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General NPI Number Information
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NPI Number | 1659973832
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Entity Type | Organization
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Legal Business Name | AETHER MEDICINE PLLC
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Dates
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Enumeration Date | 11/12/2020
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Last Update Date | 11/13/2020
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Provider Practice Location Address
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Address Line | 357 S GULPH RD STE 260
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-3174
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Country | US
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Telephone | 617-821-6232
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27935
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City | BELFAST
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State | ME
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Zip | 04915-2031
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Country | US
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Telephone | 617-821-6232
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASARE B CHRISTIAN
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Credential | MD
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Telephone | 617-821-6232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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