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General NPI Number Information
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NPI Number | 1295138477
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Entity Type | Organization
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Legal Business Name | TITLEMAN ORTHOPEDICS
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Dates
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Enumeration Date | 10/02/2014
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Last Update Date | 10/02/2014
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Provider Practice Location Address
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Address Line | 700 E TOWNSHIP LINE RD 1ST FLOOR
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City | HAVERTOWN
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State | PA
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Zip | 19083-5733
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Country | US
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Telephone | 610-724-3561
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Fax |
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Provider Business Mailing Address
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Address Line | 8 N 5TH ST GROUND FLOOR
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City | SUNBURY
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State | PA
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Zip | 17801-2392
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Country | US
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Telephone | 215-722-0751
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MR. MICHAEL K KEENE
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Credential | BOCO
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Telephone | 215-722-0751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 42496672
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License Number State | PA
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