Professional Providers INC

NPI #1821039132 in Exton, Pennsylvania

Provider Information

NPI Number: 1821039132
Entity Type: Organization
Organization Name: Professional Providers INC
Primary Specialty: Internal Medicine
Enumeration Date: Jun 9, 2006
Last Updated: Oct 1, 2012

Practice Location

Address: 119 E UWCHLAN AVE
Address 2: SUITE 201
City: Exton
State: Pennsylvania
ZIP Code: 19341-1206
Phone: (610) 363-1995

Authorized Official

Name: MARTIN LEBOUTILLIER III, MD
Title: PHYSICIAN
Phone: (610) 738-8016

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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