| NPI | 1124542170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE CLARK Owner 585-267-9547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 024340) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: NY 024340) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2017-11-10 |