| NPI | 1255146726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID KHATIB Owner 716-923-4617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 261QR0400X Clinic/Center Rehabilitation |
| Enumeration Date | 2025-02-11 |
| Last Update Date | 2025-02-23 |