| Saint Vincent Sports Medicine | |
|
4671 W Lake Rd Erie PA 16505-1441 | |
| (814) 835-2035 | |
| (814) 835-2806 |
| Full Name | Saint Vincent Sports Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 4671 W Lake Rd, Erie, Pennsylvania |
| Authorized Official Name and Position | Patricia Ballman (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8144525296 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Saint Vincent Sports Medicine 3530 Peach St Suite Ll1 Erie PA 16508-2768 Ph: (814) 860-5036 | Saint Vincent Sports Medicine 4671 W Lake Rd Erie PA 16505-1441 Ph: (814) 835-2035 |
| NPI Number | 1306931134 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 11/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306931134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Secondary |
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