Organization
SMR BANYAN TREE, INC.
Active
Other names
Banyan Tree Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAYNE FLECK POOL (CHIEF COMPLIANCE OFFICER)
(469) 467-8705
Entity
Organization
Contact information
Practice address
3262 CENTER RD, SUITE B, POLAND, OH 44514-2290
(330) 707-1190
(330) 707-1191
Mailing address
PO BOX 1245, INDIANA, PA 15701-5245
(724) 465-3496
(215) 413-4682
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
07/03/2006
Last updated
06/28/2010
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