| NPI | 1790395499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE JENKINS President 917-261-4414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 101Y00000X Counselor |
| 225100000X Physical Therapist | |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2024-09-13 |