| NPI | 1942380969 |
|---|---|
| Other Name | LLC |
| Entity Type | Organization |
| Authorized Contact | MICHELE R KING Member 315-207-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2021-06-09 |