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Organization

RIDGE AVENUE SPORTS MEDICINE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS MARCY LEA SOCRATES (OFFICE MANAGER)
(484) 664-7700
Entity
Organization

Contact information

Practice address
1150 GLENLIVET DR, A-21, ALLENTOWN, PA 18106-3112
(484) 664-7700
(484) 664-7701
Mailing address
514 N 24TH ST, ALLENTOWN, PA 18104-4917
(484) 664-7700
(484) 664-7701

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
MD025425E
PA

Other

Enumeration date
05/23/2011
Last updated
05/23/2011
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