| NPI | 1629608732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AL MANJOORSA President 347-968-8304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2020-01-17 |