| NPI | 1629859301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK TYLER WINBERG Owner 315-338-3963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2023-10-10 |
| Last Update Date | 2025-01-24 |