| NPI | 1720848302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENZA REID Office Manager 631-800-0030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2024-03-20 |