| NPI | 1720436769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILMER AVANCY LACSON President/Owner 917-484-1465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 0157731) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2016-06-01 |