Provider Demographics
NPI:1467860296
Name:SELECT CARE PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:SELECT CARE PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PROMODH
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:231-937-8485
Mailing Address - Street 1:7762 FEDERAL RD
Mailing Address - Street 2:
Mailing Address - City:HOWARD CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49329-5100
Mailing Address - Country:US
Mailing Address - Phone:231-937-8485
Mailing Address - Fax:231-937-9836
Practice Address - Street 1:7762 FEDERAL RD
Practice Address - Street 2:
Practice Address - City:HOWARD CITY
Practice Address - State:MI
Practice Address - Zip Code:49329-5100
Practice Address - Country:US
Practice Address - Phone:231-937-8485
Practice Address - Fax:231-937-9836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation