Healthcare Provider Details
I. General information
NPI: 1417320151
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: 11/03/2015
Last Update Date: 12/11/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
210 CLEAVER FARM RD SUITE 1
MIDDLETOWN DE
19709-1630
US
IV. Provider business mailing address
1050 INDUSTRIAL DR STE 210
MIDDLETOWN DE
19709-2803
US
V. Phone/Fax
- Phone: 302-449-2047
- Fax:
- Phone: 302-449-2048
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
BINSTEIN
Title or Position: VP, AUTHORIZED OFFICIAL
Credential:
Phone: 713-297-7000