Organization Name: | SEACOAST ORTHOPEDICS AND SPORTS MEDICINE LLC |
NPI Number: | 1306245634 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENNETH J GLAZIER (PRESIDENT) |
Mailing Address: | 21 Highland Ave Suite 16 Newburyport |
State: | MA US |
Postal Code: | 019503872 |
Phone Number: | 9784627555 |
Fax Number: | |
NPI Enumeration Date: | 08/22/2014 |
NPI Last Update Date: | 08/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |