| NPI | 1073717542 |
|---|---|
| Other Name | REVERB PT PC |
| Entity Type | Organization |
| Authorized Contact | KENNEDY NAGUIT REYES President 718-805-6537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 023615) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2007-08-10 |