| NPI | 1972728509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE CSANDI Manager 203-333-7788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CT 031959) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CT 001538) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2025-09-11 |