| NPI | 1376819672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL B LAZO President 347-576-1604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: 020711) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2012-03-30 |