| NPI | 1275014938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE LEWIS Owner 607-768-3540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: DC PT871842) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-08-22 |