Organization
SN KENTUCKIANA REHAB, LLC
Active
Parent organization
SELECT MEDICAL
Other names
KORT Kids -Madison
Organization subpart
Yes
Provider details
NPI number
Legal business name
SELECT MEDICAL
Authorized official
MICHAEL TARVIN (VICE PRESIDENT)
(717) 972-1100
Entity
Organization
Contact information
Practice address
2420 WILSON AVE, MADISON, IN 47250-2135
(812) 265-8226
Mailing address
4714 GETTYSBURG RD, MECHANICSBURG, PA 17055-4325
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
08/30/2022
Last updated
10/28/2022
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