| NPI | 1235466954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA P. BEASOCK Physical Therapist 315-376-3728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 008822-1) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 4293) |
| 235Z00000X Speech-Language Pathologist, (Licence: NY 008541-1) | |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2009-11-17 |