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Organization

ORTHOPAEDIC & SPORTS MEDICINE OF ERIE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLENE A KELLERMAN (PRACTICE ADMINISTRATOR)
(814) 454-8287
Entity
Organization

Contact information

Practice address
300 YORK ST, CORRY, PA 16407-1420
(814) 664-9866
(814) 454-8470
Mailing address
300 STATE ST, #400A, ERIE, PA 16507-1427
(814) 454-8287
(814) 454-8470

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0012321160003
PA
Enumeration date
03/19/2008
Last updated
03/19/2008
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