| NPI | 1811132186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA LORI HERR Owner 516-731-1980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 019821) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NY x007197) |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2022-08-05 |