Healthcare Provider Details

I. General information

NPI: 1386174399
Provider Name (Legal Business Name): RECONSTRUCTIVE ORTHOPAEDICS ASSOCIATES II, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2017
Last Update Date: 06/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 TOWNSHIP LINE RD FL 1
BLUE BELL PA
19422-2721
US

IV. Provider business mailing address

833 CHESTNUT ST STE 1402
PHILADELPHIA PA
19107-4404
US

V. Phone/Fax

Practice location:
  • Phone: 800-321-9999
  • Fax:
Mailing address:
  • Phone: 267-339-3603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL E. WEST
Title or Position: CEO
Credential:
Phone: 267-339-3680