| NPI | 1962840447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNARD R BEAUPIN Sole Member 716-447-6936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 248678) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2018-03-17 |