Individual
MR. RAYMOND EARL DYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04375R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114103
—
LA
01
—
2513209
AETNA HMO PROVIDER#
LA
01
—
7981142
AETNA NON HMO PROVIDER#
LA
Enumeration date
10/25/2005
Last updated
11/02/2007
Update your record
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