Provider Demographics
NPI:1144281874
Name:SELECT PHYSICAL THERAPY OF OHIO LIMITED PARTNERSHIP
Entity type:Organization
Organization Name:SELECT PHYSICAL THERAPY OF OHIO LIMITED PARTNERSHIP
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:717-975-4503
Mailing Address - Street 1:4575 WINCHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-5605
Mailing Address - Country:US
Mailing Address - Phone:614-920-2800
Mailing Address - Fax:
Practice Address - Street 1:4575 WINCHESTER PIKE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-5605
Practice Address - Country:US
Practice Address - Phone:614-920-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH366636Medicare ID - Type UnspecifiedPROVIDER NUMBER