| NPI | 1982949624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EWALD ANTOINE President 718-513-6440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0805X |
| Additional Taxonomies | 111N00000X Chiropractor |
| 213EP1101X Podiatrist, Primary Podiatric Medicine | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2012-12-06 |