Provider Demographics
NPI:1427011915
Name:SELECT PHYSICAL THERAPY HOLDINGS, INC.
Entity Type:Organization
Organization Name:SELECT PHYSICAL THERAPY HOLDINGS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-972-1100
Mailing Address - Street 1:803 N THOMPSON LN
Mailing Address - Street 2:STE A 103
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-4329
Mailing Address - Country:US
Mailing Address - Phone:615-890-7610
Mailing Address - Fax:
Practice Address - Street 1:803 N THOMPSON LN
Practice Address - Street 2:STE A 103
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-4329
Practice Address - Country:US
Practice Address - Phone:615-890-7610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN446601Medicare Oscar/Certification