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Individual
WILLIAM C. DMYTRIW
Active
Individual
WILLIAM C. DMYTRIW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6590
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A007
TRICARE
—
01
—
IMS67413
BCBS
—
Enumeration date
03/20/2007
Last updated
12/07/2007
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