| Progressive Sports Medicine, Pc | |
|
404 Mcfarlan Rd Suite 201 Kennett Square PA 19348-2479 | |
| (610) 444-5406 | |
| (610) 444-5907 |
| Full Name | Progressive Sports Medicine, Pc |
|---|---|
| Speciality | Family Medicine - Sports Medicine |
| Location | 404 Mcfarlan Rd, Kennett Square, Pennsylvania |
| Authorized Official Name and Position | Michael J. Graveley (OWNER) |
| Authorized Official Contact | 6104445406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Sports Medicine, Pc 404 Mcfarlan Rd Suite 201 Kennett Square PA 19348-2479 Ph: (610) 444-5406 | Progressive Sports Medicine, Pc 404 Mcfarlan Rd Suite 201 Kennett Square PA 19348-2479 Ph: (610) 444-5406 |
| NPI Number | 1780806240 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 04/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780806240 | NPI | - | NPPES |
| 101967721-0001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Pennsylvania) | Secondary |
| 207QS0010X | Family Medicine - Sports Medicine | (Pennsylvania) | Primary |
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