| NPI | 1972655041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC P WAHL Physical Therapist 631-208-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: NY 019081-1) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-08-22 |