Healthcare Provider Details

I. General information

NPI: 1831261700
Provider Name (Legal Business Name): EDELMAN SPINE & ORTHOPAEDIC PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 WOLF CREEK BLVD STE 2
DOVER DE
19901-4968
US

IV. Provider business mailing address

97 COMMERCE WAY SUITE 101
DOVER DE
19904-8228
US

V. Phone/Fax

Practice location:
  • Phone: 302-734-8000
  • Fax: 302-734-0102
Mailing address:
  • Phone: 302-734-8000
  • Fax: 302-734-0102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberJ1-0001503
License Number StateDE

VIII. Authorized Official

Name: GEORGE T EDELMAN
Title or Position: OWNER
Credential: PT
Phone: 302-734-8000