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NPI 1205458973

NPI 1205458973 : DYNAMIC MEDICAL HEALTH AND EDUCATION : KING OF PRUSSIA, PA

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General NPI Number Information
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    NPI Number           |    1205458973
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    Entity Type          |    Organization 
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    Legal Business Name  |    DYNAMIC MEDICAL HEALTH AND EDUCATION 
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Dates
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    Enumeration Date     |    05/15/2020
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    Last Update Date     |    05/15/2020
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Provider Practice Location Address
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    Address Line         |    1012 W 9TH AVE STE 115 
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    City                 |    KING OF PRUSSIA
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    State                |    PA
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    Zip                  |    19406-1093
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    Country              |    US
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    Telephone            |    484-803-3601
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 273 
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    City                 |    SPRING CITY
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    State                |    PA
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    Zip                  |    19475-0273
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    Country              |    US
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    Telephone            |    484-803-3601
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |    DR. HIGHLAND R CAMPBELL II
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    Credential           |    MD
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    Telephone            |    484-803-3601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QH0100X
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    Taxonomy Name        |    Health Service Clinic/Center
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    License Number       |    
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    License Number State |    
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