| NPI | 1861235913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN THOMAS Owner 347-933-3019 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 111N00000X Chiropractor |
| 171100000X Acupuncturist | |
| 207LP2900X Anesthesiology Pain Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| 225100000X Physical Therapist | |
| 225200000X Physical Therapy Assistant | |
| Enumeration Date | 2024-06-17 |
| Last Update Date | 2024-06-17 |