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Organization
PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES LTD
Active
Organization
PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM STOTT (ADMINISTRATIVE MANAGER)
(610) 359-5664
Entity
Organization
Contact information
Practice address
525 W CHESTER PIKE, STE 203, HAVERTOWN, PA 19083-4500
(610) 789-7767
(610) 789-7768
Mailing address
525 W CHESTER PIKE, STE 203, HAVERTOWN, PA 19083-4500
(610) 789-7767
(610) 789-7768
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD070801L
PA
208100000X
Physical Medicine & Rehabilitation Physician
MD430669
PA
208100000X
Physical Medicine & Rehabilitation Physician
OS009727L
PA
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
05/27/2010
Last updated
11/18/2013
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