| NPI | 1154692010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA JAHN Owner 631-360-9075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251G0304X Physical Therapist Geriatrics |
| 2251H1200X Physical Therapist Hand | |
| 2251N0400X Physical Therapist Neurology | |
| 2251S0007X Physical Therapist Sports | |
| 2251X0800X Physical Therapist Orthopedic | |
| Enumeration Date | 2012-01-24 |
| Last Update Date | 2012-01-24 |