| NPI | 1003788001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELBY WITHIAM Physical Therapist 607-423-0641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2025-09-19 |
| Last Update Date | 2025-09-19 |