Provider Demographics
NPI:1578594123
Name:MYERS, JEFFREY M (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:MYERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:MYERS
Other - Middle Name:CHIROPRACTIC
Other - Last Name:CLINIC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3 HAMPTON ROAD
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4807
Mailing Address - Country:US
Mailing Address - Phone:603-772-3981
Mailing Address - Fax:603-772-7545
Practice Address - Street 1:3 HAMPTON ROAD
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4807
Practice Address - Country:US
Practice Address - Phone:603-772-3981
Practice Address - Fax:603-772-7545
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH427A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH058639YONHOOtherANTHEM BCBS
NH058639YONHOOtherANTHEM BCBS
T87490Medicare UPIN