| Legion Therapeutic Group, Llc | |
|
14 Elliott Ave Suite 9 Bryn Mawr PA 19010-3412 | |
| (844) 534-4661 | |
| (888) 226-4103 |
| Full Name | Legion Therapeutic Group, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 14 Elliott Ave, Bryn Mawr, Pennsylvania |
| Authorized Official Name and Position | Michael M Green (FOUNDER) |
| Authorized Official Contact | 2675950588 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legion Therapeutic Group, Llc 3553 W Chester Pike Unit 320 Newtown Square PA 19073-3701 Ph: (844) 534-4661 | Legion Therapeutic Group, Llc 14 Elliott Ave Suite 9 Bryn Mawr PA 19010-3412 Ph: (844) 534-4661 |
| NPI Number | 1437681038 |
|---|---|
| Provider Enumeration Date | 04/02/2017 |
| Last Update Date | 04/02/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437681038 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | PC008692 (Pennsylvania) | Primary |
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