| NPI | 1578869608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON MARIE SULLIVAN Manager 315-379-0992 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2011-02-08 |
| Last Update Date | 2011-02-08 |