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Organization
MAIN LINE WELLNESS LLC
Active
Organization
MAIN LINE WELLNESS LLC
Active
Parent organization
ROY M LERMAN MD PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROY M LERMAN MD PC
Authorized official
DR. ROY LERMAN MD (MANAGING PARTNER)
(610) 337-3111
Entity
Organization
Contact information
Practice address
700 S HENDERSON RD STE 308C, KING OF PRUSSIA, PA 19406-4206
(610) 337-3111
(610) 233-1272
Mailing address
700 S HENDERSON RD STE 308C, KING OF PRUSSIA, PA 19406-4206
(610) 337-3111
(610) 233-1272
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1234567
STARTING CREDENTIALING PROCESS
PA
Enumeration date
10/11/2019
Last updated
10/11/2019
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