| NPI | 1376798652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD CHMIELEWSKI Owner 315-507-4751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207RA0401X Internal Medicine Addiction Medicine | |
| Enumeration Date | 2008-11-30 |
| Last Update Date | 2022-10-27 |