Individual
ELIZABETH CHAM DMYTRIW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3001 EDWARDS MILL RD, 200, RALEIGH, NC 27612-5243
(919) 781-4060
(919) 781-5246
Mailing address
2000 PERIMETER PARK DR, STE 200, MORRISVILLE, NC 27560-8442
(984) 215-4110
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13912
NC
225100000X
Physical Therapist
40QA01014700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
086057N5C
MEDICARE ID
NJ
Enumeration date
10/18/2006
Last updated
01/13/2021
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