Healthcare Provider Details
I. General information
NPI: 1538287644
Provider Name (Legal Business Name): HEALTH ACCESS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2007
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
196 W SPROUL RD SUITE 110
SPRINGFIELD PA
19064-2045
US
IV. Provider business mailing address
PO BOX 8500-6355
PHILADELPHIA PA
19178-0001
US
V. Phone/Fax
- Phone: 610-328-8830
- Fax: 610-328-8981
- Phone: 610-497-7520
- Fax: 610-497-7525
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
BRAD
PRECHTL
Title or Position: PRESIDENT
Credential:
Phone: 610-338-8386