| NPI | 1922230788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY FORTIN LOMBOY President 718-886-0556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 028236) |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2009-08-12 |