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Individual
MR. SCOTT M WIRTH
Active
Individual
MR. SCOTT M WIRTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-015955
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00915453
MEDICARE RAILROAD
IL
Enumeration date
06/19/2007
Last updated
05/27/2011
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