| NPI | 1174019681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN JORSTAD JAKOBSEN Medical Director 347-744-8605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 197596) |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2018-07-09 |