| NPI | 1073385738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE RUSSETTE Credentialing 586-552-4573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand |
| Enumeration Date | 2023-10-26 |
| Last Update Date | 2023-10-26 |