| NPI | 1790778983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN CANAVAN Owner/Operator 315-475-7121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 010239) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2008-05-06 |