Provider Demographics
NPI:1336101385
Name:MYERS, MARIE B (ATC)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:B
Last Name:MYERS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:798 HAUSMAN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9108
Mailing Address - Country:US
Mailing Address - Phone:610-395-5300
Mailing Address - Fax:610-395-5551
Practice Address - Street 1:798 HAUSMAN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9108
Practice Address - Country:US
Practice Address - Phone:610-395-5300
Practice Address - Fax:610-395-5551
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PART001889A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer