| NPI | 1003064452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YEV FEDOSENKO President 617-620-2137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NJ 40QA01242600) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2015-03-12 |