| NPI | 1538391099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN MICHAEL GERVASIO Owner 516-541-8933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: NY X011710-1) |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2009-08-18 |