Organization
PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES LTD
Active
Parent organization
PREMIER ORTHOPAEDIC & SPORTS MEDICINE ASSO., LTD.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PREMIER ORTHOPAEDIC & SPORTS MEDICINE ASSO., LTD.
Authorized official
HEATHER DEFAZIO (EXECUTIVE ASSISTANT)
(610) 692-6280
Entity
Organization
Contact information
Practice address
455 WOODVIEW RD STE 205, WEST GROVE, PA 19390-9315
(484) 748-6148
(610) 869-2320
Mailing address
915 OLD FERN HILL ROAD, BLDG A STE 1, WEST CHESTER, PA 19380-4269
(610) 692-6280
(610) 429-1943
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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