| NPI | 1306979075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANTHONY PACCHIANO Owner 719-356-2919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 021520-1) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2024-02-23 |