| NPI | 1245728757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANILO SHANE DE CASTRO BADIOLA PT 347-465-0763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 016105) |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2018-04-30 |