| NPI | 1952748311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY DAVID WINCHELL Physical Therapist/Part Owner 315-820-8014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2013-05-25 |
| Last Update Date | 2013-05-25 |