| NPI | 1851454847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORELEI DAVIDSON President 845-628-2004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NY 206144) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2016-08-30 |