| NPI | 1154629715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE MARGARET WANMER Owner 518-383-2610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 019934-1) |
| Enumeration Date | 2011-03-07 |
| Last Update Date | 2011-06-10 |