| Organization Name: | SMR BANYAN TREE, INC. |
| NPI Number: | 1255361556 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAYNE FLECK POOL (CHIEF COMPLIANCE OFFICER) |
| Mailing Address: | 3262 Center Rd Suite B Poland |
| State: | OH US |
| Postal Code: | 445142290 |
| Phone Number: | 3307071190 |
| Fax Number: | 3307071191 |
| NPI Enumeration Date: | 07/03/2006 |
| NPI Last Update Date: | 06/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |