| NPI | 1073918371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINO IRWIN B REYES Ambr 518-407-3422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT7862) |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation (Licence: FL PT0007862) |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2015-03-24 |