| NPI | 1265579213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORELEI DAVIDSON President 845-628-2004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NY 206144) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |