| NPI | 1285849703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE ALEXANDER Main Doctor 7183-029-4974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 229782) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 026645) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |