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 |