| NPI | 1427714948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW R VANSLYKE Physical Therapist 518-332-1602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2021-11-09 |