| NPI | 1053172783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKOLE WILLMAN Owner 631-897-7038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QX0100X Clinic/Center, Occupational Medicine |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2024-01-19 |
| Last Update Date | 2024-01-19 |