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General NPI Number Information
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NPI Number | 1861464505
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Entity Type | Individual
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Provider Name | WALTER WITRYOL M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1464 JEFFERSON ST N
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City | LEWISBURG
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State | WV
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Zip | 24901-1380
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Country | US
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Telephone | 304-645-3220
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Fax | 844-479-4545
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Provider Business Mailing Address
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Address Line | PO BOX 720
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City | MANCHESTER
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State | CT
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Zip | 06045-0720
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Country | US
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Telephone | 860-646-1222
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Fax | 860-533-2975
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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 | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | L8232
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | D68048
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 32407
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License Number State | WV
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