| NPI | 1780080218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY PUTNAM Managing Employee 725-710-9178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 277584) |
| Enumeration Date | 2014-11-11 |
| Last Update Date | 2024-03-27 |