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
525 W CHESTER PIKE, STE 203, HAVERTOWN, PA 19083-4500
(610) 789-7767
(610) 789-7768
Mailing address
525 W CHESTER PIKE, STE 203, HAVERTOWN, PA 19083-4500
(610) 789-7767
(610) 789-7768
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD070801L
PA
208100000X
Physical Medicine & Rehabilitation Physician
MD430669
PA
208100000X
Physical Medicine & Rehabilitation Physician
OS009727L
PA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
05/27/2010
Last updated
11/18/2013
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