| NPI | 1871032904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL PHILIP NANCOLLAS Owner 315-559-3506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: MA 257785) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: MA 553596) |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2022-03-28 |