| NPI | 1538535869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARTUR MULLOKANDOV Owner 917-362-0646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: NJ 40QA01479500) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2015-08-24 |