| NPI | 1851757090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN DOMINGO CALUBAQUIB D PT 718-213-2577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 030439) |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2016-01-04 |