| NPI | 1326572181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARAS ODULAK CEO 212-260-2213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NY 264414) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X006018) |
| 2251S0007X Physical Therapist, Sports (Licence: NY 264414) | |
| 2251S0007X Physical Therapist, Sports | |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2017-11-13 |