Provider Demographics
NPI:1073179925
Name:MYERS, JAIME MARIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:MARIE
Last Name:MYERS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:MARIE
Other - Last Name:LATENSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:2 E GREGORY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-1118
Practice Address - Country:US
Practice Address - Phone:816-926-0222
Practice Address - Fax:816-926-0277
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019026048225100000X
KS11-06140225100000X
ARCP003499T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist