Healthcare Provider Details
I. General information
NPI: 1184124323
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
20268 PLANTATIONS RD STE B
LEWES DE
19958-4622
US
IV. Provider business mailing address
1050 INDUSTRIAL RD STE 210
MIDDLETOWN DE
19709-2801
US
V. Phone/Fax
- Phone: 302-727-0075
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable 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