Provider Demographics
NPI:1326447509
Name:MYERS, ZACHARY JAMES (ATC)
Entity Type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:JAMES
Last Name:MYERS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:WEED
Mailing Address - State:CA
Mailing Address - Zip Code:96094-2899
Mailing Address - Country:US
Mailing Address - Phone:530-938-5308
Mailing Address - Fax:
Practice Address - Street 1:800 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:WEED
Practice Address - State:CA
Practice Address - Zip Code:96094
Practice Address - Country:US
Practice Address - Phone:530-938-5308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
20000043282255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer