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Organization
PROFESSIONAL PROVIDERS INC
Active
Organization
PROFESSIONAL PROVIDERS INC
Active
Other names
Whiteland Medical Associates for Progressive Health
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN LEBOUTILLIER III MD (PHYSICIAN)
(610) 738-8016
Entity
Organization
Contact information
Practice address
119 E UWCHLAN AVE, SUITE 201, EXTON, PA 19341-1206
(610) 363-1995
(610) 363-1995
Mailing address
1244 W CHESTER PIKE, SUITE 409, WEST CHESTER, PA 19382-5657
(610) 738-8016
(610) 918-6316
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/09/2006
Last updated
10/01/2012
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