| NPI | 1497440895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKHAIL KUCHER President 754-754-2757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics |
| 225XP0200X Occupational Therapist, Pediatrics | |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2023-05-04 |