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Organization
PROACTIVE PHYSICAL MEDICINE, LLC
Active
Organization
PROACTIVE PHYSICAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AILEEN QUELL (BILLING MANAGER)
(215) 321-3538
Entity
Organization
Contact information
Practice address
1331 E WYOMING AVE, SUITE 1100, PHILADELPHIA, PA 19124-3808
(215) 744-4030
(215) 744-4582
Mailing address
1331 E WYOMING AVE, SUITE 1100, PHILADELPHIA, PA 19124-3808
(215) 744-4030
(215) 744-4582
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
07/29/2007
Last updated
09/01/2009
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