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General NPI Number Information
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NPI Number | 1427263672
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Entity Type | Organization
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Legal Business Name | PIONEER VALLEY ORTHOPEDICS, INC
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 08/27/2009
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Provider Practice Location Address
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Address Line | 125 LIBERTY ST STE 402
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City | SPRINGFIELD
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State | MA
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Zip | 01103-1109
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Country | US
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Telephone | 413-781-5840
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Fax |
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Provider Business Mailing Address
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Address Line | 125 LIBERTY ST STE 402
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City | SPRINGFIELD
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State | MA
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Zip | 01103-1109
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Country | US
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Telephone | 413-781-5840
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HARVEY M GRANT
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Credential | M.D.
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Telephone | 413-781-5840
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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 | 29883
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License Number State | MA
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