| NPI | 1619360419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX MENDOZA Manager 347-784-1617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NJ 40QA01488900) |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2015-03-18 |