Provider Demographics
NPI:1235723677
Name:SELECT REHABILITATION
Entity Type:Organization
Organization Name:SELECT REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HOTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-474-6087
Mailing Address - Street 1:5334 GENESEE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BOWMANSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14026-1062
Mailing Address - Country:US
Mailing Address - Phone:716-474-6087
Mailing Address - Fax:
Practice Address - Street 1:200 OHIO ST
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:NY
Practice Address - Zip Code:14103-1063
Practice Address - Country:US
Practice Address - Phone:585-798-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty