| NPI | 1013675115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIN S WONG Owner 617-866-2899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-12-06 |
| Last Update Date | 2021-12-06 |