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Organization

SMR BANYAN TREE, INC.

Active
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Organization

SMR BANYAN TREE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL E TARVIN (VICE PRESIDENT & SECRETARY)
(717) 972-1100
Entity
Organization

Contact information

Practice address
4930 W BROAD ST, SUITE 2, COLUMBUS, OH 43228-1696
(614) 878-1634
(614) 878-1746
Mailing address
4714 GETTYSBURG ROAD, LEGAL DEPT, MECHANICSBURG, PA 17055-4325
(717) 972-1100

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—

Other

Enumeration date
07/03/2006
Last updated
11/21/2018
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