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Individual
MR. WILLIAM O WORTHINGTON
Active
Individual
MR. WILLIAM O WORTHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05005753A
IN
225100000X
Physical Therapist
Primary
070010429
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010934666
KINETIC TAX ID
IL
01
—
080647
HEALTH ALLIANCE
IL
01
—
1232012
BLUE CROSS KINETIC 2010
IL
01
—
P00397106
RAILROAD UPIN
IL
Enumeration date
07/28/2006
Last updated
06/06/2012
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