| NPI | 1922587211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER KOPACH Owner/Operator 917-334-9108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: GA PT010961) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2024-11-04 |