| NPI | 1881252294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN GOODMAN Mbr 917-270-5151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2019-05-31 |