Healthcare Provider Details

I. General information

NPI: 1215562608
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: 03/06/2020
Last Update Date: 03/06/2020
Certification Date: 03/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12100 BLACK SWAN DR STE 202
LEWES DE
19958-4988
US

IV. Provider business mailing address

1050 INDUSTRIAL RD STE 210
MIDDLETOWN DE
19709-2803
US

V. Phone/Fax

Practice location:
  • Phone: 302-644-5591
  • Fax: 302-449-2047
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