| NPI | 1306109590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SU MIN KO Owner 347-325-4390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: VA 0101250991) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2017-02-20 |