| NPI | 1629555172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HANIOTIS Authorized Official/Partner 762-204-4103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2018-07-31 |