| NPI | 1952937328 |
|---|---|
| Doing Business As | YOUR LIFE WELLNESS & PHYSICAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | JEFFREY W HATHAWAY CEO 315-458-2552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2020-03-18 |
| Last Update Date | 2020-03-18 |