| NPI | 1710414636 |
|---|---|
| Doing Business As | WEST ISLIP PTDC |
| Entity Type | Organization |
| Authorized Contact | JACK TESORIERO Owner/Chiropractor 844-301-7832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2017-05-23 |