| NPI | 1851774475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROD M FELICE Owner 315-408-8341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MD 22634) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2021-01-07 |