| NPI | 1336405299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LYNN WALKER Massage Therapist 631-487-2149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172M00000X Mechanotherapist (Licence: NY 020636-1) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2012-04-04 |