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Organization
TOWER HEALTH MEDICAL GROUP
Active
Organization
TOWER HEALTH MEDICAL GROUP
Active
Other names
Sports Medicine - Tower Health Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
GARY CONNER (SENIOR VP & CFO)
(484) 628-8181
Entity
Organization
Contact information
Practice address
1350 BROADCASTING RD STE 201, WYOMISSING, PA 19610-3229
(610) 685-9600
(610) 685-6700
Mailing address
PO BOX 13579, READING, PA 19612-3579
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072790
MEDICARE PTAN
PA
Enumeration date
03/11/2013
Last updated
06/17/2019
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