| NPI | 1669641676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE BURNS President 5169-919-6070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NY 199512) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 199512) |
| Enumeration Date | 2008-02-23 |
| Last Update Date | 2008-02-23 |