Provider Demographics
NPI:1568822120
Name:MYERS, SHARON KAY (LMT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:KAY
Last Name:MYERS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-4530
Mailing Address - Country:US
Mailing Address - Phone:410-596-7956
Mailing Address - Fax:
Practice Address - Street 1:93 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-4530
Practice Address - Country:US
Practice Address - Phone:410-596-7956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM05289225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM05289OtherMASSAGE THERAPIST