| NPI | 1962686162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT BRYAN VANKAMPEN Owner 716-951-6031 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 017397) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X008386-1) |
| 225100000X Physical Therapist (Licence: NY 017397) | |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2009-11-17 |