| NPI | 1689223919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD ROBERT WALDORF Owner / Physician 518-526-9996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2020-06-24 |