| NPI | 1215957626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY SMALL Manager 631-665-8645 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2011-01-18 |