MEDICARE: SELECT MEDICAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center	PT025306	PA

General Provider Information

NPI Number	:	1932654647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT MEDICAL

Provider Business Mailing Address
First Line	:	623 S CHESTER RD
Second Line	:
City	:	SWARTHMORE
State	:	PA
Zip	:	19081-2315
Country	:	US
Telephone Number	:	610-543-1201
Fax Number	:	610-328-5205

Provider Business Practice Location Address
First Line	:	623 S CHESTER RD
Second Line	:
City	:	SWARTHMORE
State	:	PA
Zip	:	19081-2315
Country	:	US
Telephone Number	:	610-543-1201
Fax Number	:	610-328-5205

Authorized Official
Title or Position	:	REGIONAL MANAGER
Name	:	DR. JASON HEYDUK
Credential	:	PT,DPT
Telephone Number	:	610-543-1201

Provider Enumeration Date	:	08/23/2016
Last Update Date	:	08/23/2016

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Directions to “SELECT MEDICAL ” Practice Location

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