| NPI | 1174132302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDALL BLACK Principle Physical Therapist 917-804-8707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2020-07-23 |