NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1750471124
THERA DYNAMIC PHYSICAL THERAPY P.C
1443 28TH AVE APT 2D
LONG ISLAND CITY
NY
111023663
1205194164
ABUAN
LALAINE
L
133-29 41ST ROAD SUITE 1A
FLUSHING
NY
11355
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