Provider Demographics
NPI:1083008577
Name:TITLEMAN ORTHOPEDICS LLC
Entity Type:Organization
Organization Name:TITLEMAN ORTHOPEDICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MANAER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:KEENE
Authorized Official - Suffix:JR
Authorized Official - Credentials:BOCO
Authorized Official - Phone:484-687-5041
Mailing Address - Street 1:PO BOX D
Mailing Address - Street 2:HAVETOWN
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-0204
Mailing Address - Country:US
Mailing Address - Phone:484-687-5041
Mailing Address - Fax:
Practice Address - Street 1:341 A WEST MAIN ST
Practice Address - Street 2:
Practice Address - City:BIRDSBORO
Practice Address - State:PA
Practice Address - Zip Code:19508
Practice Address - Country:US
Practice Address - Phone:484-687-5041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier