| NPI | 1235574963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILDER RUCKER Owner 914-747-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NY 264414) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2013-05-08 |