| NPI | 1811097306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD RYAN SMITH Director Physical Therapist 631-585-5915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 022363) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2020-08-22 |