Organization
PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT LEGOWSKI (OPERATIONS)
(609) 703-5097
Entity
Organization
Contact information
Practice address
525 W CHESTER PIKE, SUITE 203, HAVERTOWN, PA 19083-4500
(610) 789-7768
Mailing address
525 W CHESTER PIKE, SUITE 203, HAVERTOWN, PA 19083-4500
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
MD070801L
PA
Other
Enumeration date
10/12/2016
Last updated
10/12/2016
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