| NPI | 1992266753 |
|---|---|
| Doing Business As | CHANGE THE GAME PERFORMANCE THERAPY |
| Entity Type | Organization |
| Authorized Contact | RYAN GODFREY Owner/Physical Therapist 315-292-8976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2019-03-26 |