| NPI | 1518105162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK WALLACE Owner/Physical Therapy 516-869-5576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 030964-1) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2009-09-03 |