| NPI | 1467966432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW KOLTUN Owner 516-578-8967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CO 0011130) |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2017-11-28 |