Provider Demographics
NPI:1477069748
Name:MYERS, ELIZABETH A (PT, OCS)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:A
Last Name:MYERS
Suffix:
Gender:F
Credentials:PT, OCS
Other - Prefix:DR
Other - First Name:BETSY
Other - Middle Name:
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, OCS
Mailing Address - Street 1:826 VINE ST APT C
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2342
Mailing Address - Country:US
Mailing Address - Phone:918-281-9996
Mailing Address - Fax:
Practice Address - Street 1:6585 S YALE AVE STE 445
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-9703
Practice Address - Country:US
Practice Address - Phone:918-481-2977
Practice Address - Fax:918-481-2976
Is Sole Proprietor?:No
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10500225100000X
OK3594225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist