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Organization
SMR BANYAN TREE, INC.
Active
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
5514 NIKE DR, HILLIARD, OH 43026-9081
(614) 529-8733
(614) 529-6751
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
06/22/2006
Last updated
11/21/2018
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