Provider Demographics
NPI:1114954914
Name:MYERS, JENAY DUNLAP (ATC, LAT)
Entity Type:Individual
Prefix:MRS
First Name:JENAY
Middle Name:DUNLAP
Last Name:MYERS
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 741200
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-1301
Mailing Address - Country:US
Mailing Address - Phone:770-603-8810
Mailing Address - Fax:770-603-8810
Practice Address - Street 1:100 INTERPACE PKWY
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1149
Practice Address - Country:US
Practice Address - Phone:800-433-4115
Practice Address - Fax:770-603-8810
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer