| NPI | 1043766975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON TYLER WHITWORTH Owner/Physical Therapist 631-790-9798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: TN 10299) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2018-05-24 |