| NPI | 1780846154 |
|---|---|
| Doing Business As | DBA DYNAMIC SPORTS PHYSICAL THERAPY & REHABILITATION |
| Entity Type | Organization |
| Authorized Contact | LAURA ELLIS Credentialing/Biller 631-470-9515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2008-08-12 |