| Organization Name: | GERMANTOWN PAIN MANAGEMENT |
| NPI Number: | 1538360334 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KELLY J BOYLE (MEDICAL ASSISTANT) |
| Mailing Address: | 5537 Germantown Ave Philadelphia |
| State: | PA US |
| Postal Code: | 191442225 |
| Phone Number: | 2158483708 |
| Fax Number: | 2158483216 |
| NPI Enumeration Date: | 05/30/2007 |
| NPI Last Update Date: | 05/08/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |