| NPI | 1194805705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY STUART KOGON Owner/President 302-998-7572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE 1989030935) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2024-04-24 |