| NPI | 1730573510 |
|---|---|
| Other Name | FULL POTENTIAL SPORTS CARE |
| Entity Type | Organization |
| Authorized Contact | JOHN M RUDDY Owner 631-786-9147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY 011261) |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2015-03-19 |