| NPI | 1124298005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY JO DAVISON Director 518-567-9977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NY 243611) |
| Additional Taxonomies | 2081N0008X Physical Medicine & Rehabilitation Neuromuscular Medicine (Licence: NY 243611) |
| 208D00000X General Practice (Licence: NY 243611) | |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2008-03-06 |