| NPI | 1164688263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH ETZL Office Manager 607-431-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 136114-1) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY x010988) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2008-07-29 |