| NPI | 1982328597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A WALLMAN Provider/AO/Owner 631-265-1727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2022-09-27 |
| Last Update Date | 2025-04-24 |