| NPI | 1578066593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS LONG Owner 718-206-3369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-03-15 |