| NPI | 1821486481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON REGNER Owner 518-632-4944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 0254361) |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2015-01-06 |