Healthcare Provider Details

I. General information

NPI: 1629264577
Provider Name (Legal Business Name): OCCUPATIONAL HEALTH & PAIN MANAGEMENT OF CHESTER COUNTY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2007
Last Update Date: 08/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 CREAMERY WAY STE 104
EXTON PA
19341-2533
US

IV. Provider business mailing address

460 CREAMERY WAY STE 104
EXTON PA
19341-2533
US

V. Phone/Fax

Practice location:
  • Phone: 610-524-0770
  • Fax: 610-524-0772
Mailing address:
  • Phone: 610-524-0770
  • Fax: 610-524-0772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD049402L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. BRIAN D PIERSON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 610-524-0770