| NPI | 1457794331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD M PANETTA Member 315-404-7202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2013-04-10 |