| NPI | 1972257541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEB KARTSEV Member 929-800-2011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2022-02-11 |
| Last Update Date | 2022-02-11 |