| NPI | 1053390666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY M CHASE Owner/President 340-714-2845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: VI 1122) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: VI 2509) |
| 225100000X Physical Therapist (Licence: VI 131) | |
| 363A00000X Physician Assistant (Licence: VI 068) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2022-07-21 |