Basic Information
Provider Information
NPI: 1245466309
EntityType: 2
ReplacementNPI:  
OrganizationName: SELECT PHYSICAL THERAPY HOLDINGS INC
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Mailing Information
Address1: 4714 GETTYSBURG RD
Address2: LEGAL DEPT
City: MECHANICSBURG
State: PA
PostalCode: 170554325
CountryCode: US
TelephoneNumber: 7179721100
FaxNumber:  
Practice Location
Address1: 86 S COBB DR
Address2:  
City: MARIETTA
State: GA
PostalCode: 300630001
CountryCode: US
TelephoneNumber: 7179721100
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/03/2009
LastUpdateDate: 06/03/2009
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: TARVIN
AuthorizedOfficialFirstName: MICHAEL
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: VICE PRESIDENT
AuthorizedOfficialTelephone: 7179754503
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QP2000X  Y Ambulatory Health Care FacilitiesClinic/CenterPhysical Therapy

No ID Information.


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