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Individual

ALFRED JAMES DYER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
134 S COLLEGE AVE, BLUEFIELD, VA 24605-1705
(276) 325-5020
(276) 325-5029
Mailing address
1400 AUGUSTA ST, BLUEFIELD, WV 24701-3810
(304) 960-1637

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
001290
WV
225100000X
Physical Therapist
Primary
2305006291
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4059211
MEDICARE PTAN
05
7301086-000
WV
Enumeration date
10/17/2006
Last updated
11/20/2015
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