| NPI | 1326585498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN BRUSH Credentialing COO Rdinator Manager 631-359-5859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2018-03-28 |