| NPI | 1235828773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER J KALLASY Owner, Physical Therapist 315-749-6853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2023-05-02 |
| Last Update Date | 2023-05-02 |