| NPI | 1982880951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSS L'HOMMEDIEU Owner 631-477-6035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 011600) |
| Enumeration Date | 2008-01-21 |
| Last Update Date | 2008-01-21 |