| NPI | 1861297236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DMITRIY DOROTOV Manager 267-266-8403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2025-02-18 |
| Last Update Date | 2025-02-18 |