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General NPI Number Information
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NPI Number | 1689010670
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC MUSCLE SOLUTIONS
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Dates
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Enumeration Date | 05/16/2013
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Last Update Date | 05/16/2013
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Provider Practice Location Address
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Address Line | 168 HUDSON DR
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-5648
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Country | US
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Telephone | 484-682-4442
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Fax | 801-504-4336
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Provider Business Mailing Address
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Address Line | 168 HUDSON DR
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-5648
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Country | US
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Telephone | 484-682-4442
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Fax | 801-504-4336
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MR. DEREK LEE SOMERVILLE
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Credential | LMT, COTA
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Telephone | 484-682-4442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | OP006867
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License Number State | PA
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