| NPI | 1609054931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH RUSSELL MARVIN Owner 845-735-4755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: NY X008559-1) |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2008-02-08 |