| NPI | 1013886613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN DELGADO VELASCO Manager 347-549-3299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2025-11-03 |
| Last Update Date | 2025-11-03 |