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General NPI Number Information
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NPI Number | 1255503181
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Entity Type | Organization
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Legal Business Name | PREMIER ORTHOPAEDICS AND SPORTS MEDICINE
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Dates
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Enumeration Date | 04/01/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | ONE MEDICAL CENTER BLVD. POB II, SUITE 324
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City | UPLAND
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State | PA
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Zip | 19015
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Country | US
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Telephone | 610-876-0347
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Fax | 610-872-4759
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Provider Business Mailing Address
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Address Line | PO BOX 81
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City | BRYN MAWR
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State | PA
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Zip | 19010-0081
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Country | US
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Telephone | 610-876-0347
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Fax | 610-872-4759
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Authorized Official
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Title or Position | BILLING CLERK
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Name | JODY FRY
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Credential |
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Telephone | 610-876-0347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | PA
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