| NPI | 1114262318 |
|---|---|
| Other Name | SPROUT THERAPY GROUP |
| Entity Type | Organization |
| Authorized Contact | JEFFREY S DORFMAN Chief Operating Officer 315-450-4898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2012-11-29 |