| NPI | 1770060485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE BALZER Owner 518-708-3980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: NY 037714) |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2018-07-25 |