Provider Demographics
NPI:1588955678
Name:AOPM, LLC
Entity type:Organization
Organization Name:AOPM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JARRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:TELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-352-1710
Mailing Address - Street 1:PO BOX 95
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-0095
Mailing Address - Country:US
Mailing Address - Phone:610-352-1710
Mailing Address - Fax:
Practice Address - Street 1:7000 TERMINAL SQ STE 100B
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-2315
Practice Address - Country:US
Practice Address - Phone:610-352-1710
Practice Address - Fax:610-352-1740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007527-L111N00000X
PADC10647111N00000X
PAMD035566E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6697440001Medicare NSC
PA240246Medicare PIN