Provider Demographics
NPI:1407038458
Name:MYERS, JONATHAN ALLEN (OTR)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:ALLEN
Last Name:MYERS
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 APACHE DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-5902
Mailing Address - Country:US
Mailing Address - Phone:870-740-3886
Mailing Address - Fax:
Practice Address - Street 1:1208 W PLEASURE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-5151
Practice Address - Country:US
Practice Address - Phone:870-740-3886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-01
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2146225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist