Healthcare Provider Details

I. General information

NPI: 1922616820
Provider Name (Legal Business Name): DYNAMIC INJURY SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2020
Last Update Date: 07/16/2020
Certification Date: 07/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6778 MARKET ST
UPPER DARBY PA
19082-2432
US

IV. Provider business mailing address

301 E CITY AVE # LL1
BALA CYNWYD PA
19004-1708
US

V. Phone/Fax

Practice location:
  • Phone: 215-473-1500
  • Fax:
Mailing address:
  • Phone: 610-257-3138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SIDNEY ZILBER
Title or Position: GENERAL COUNSEL
Credential:
Phone: 215-425-1500