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
1 BARTOL AVE, STE 100, RIDLEY PARK, PA 19078-2214
(610) 521-8970
(610) 521-3983
Mailing address
PO BOX 5228, WEST CHESTER, PA 19380-0405
(610) 359-6571
(610) 521-3983
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
06/02/2010
Last updated
02/10/2022
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