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General NPI Number Information
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NPI Number | 1184705204
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Entity Type | Individual
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Provider Name | ALFRED JAMES DYER PT
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Gender | Male
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 11/20/2015
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Provider Practice Location Address
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Address Line | 134 S COLLEGE AVE
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City | BLUEFIELD
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State | VA
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Zip | 24605-1705
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Country | US
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Telephone | 276-325-5020
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Fax | 276-325-5029
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Provider Business Mailing Address
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Address Line | 1400 AUGUSTA ST
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City | BLUEFIELD
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State | WV
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Zip | 24701-3810
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Country | US
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Telephone | 304-960-1637
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 001290
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305006291
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License Number State | VA
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