Healthcare Provider Details

I. General information

NPI: 1548760788
Provider Name (Legal Business Name): PREMIER PHYSICAL THERAPY AND SPORTS PERFORMANCE LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2018
Last Update Date: 02/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

642 S QUEEN ST STE 101
DOVER DE
19904-3506
US

IV. Provider business mailing address

1050 INDUSTRIAL RD STE 210
MIDDLETOWN DE
19709-2801
US

V. Phone/Fax

Practice location:
  • Phone: 302-724-6344
  • Fax:
Mailing address:
  • Phone: 302-449-2048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: RICHARD BINSTEIN
Title or Position: VP/AUTHORIZED OFFICIAL
Credential:
Phone: 713-297-7000