1538120654 NPI number — SELECT PHYSICAL THERAPY HOLDINGS INC

Table of content: (NPI 1538120654)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538120654 NPI number — SELECT PHYSICAL THERAPY HOLDINGS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SELECT PHYSICAL THERAPY HOLDINGS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538120654
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
10/29/2007
NPI Reactivation Date:
12/13/2007

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4716 OLD GETTYSBURG RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MECHANICSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17055
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-975-4503
Provider Business Mailing Address Fax Number:
717-975-9981

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
449 W MT PLEASANT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIVINGSTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-994-4300
Provider Business Practice Location Address Fax Number:
973-944-7923
Provider Enumeration Date:
03/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TARVIN
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
E
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
717-975-4503

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QR0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com