| NPI | 1679151781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL REDNER Sole Owner 315-765-0903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2021-03-30 |