Provider Demographics
NPI:1629090873
Name:MYERS, LOWELL B II (DC)
Entity Type:Individual
Prefix:MR
First Name:LOWELL
Middle Name:B
Last Name:MYERS
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 CANTON RD NW
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:44615-8426
Mailing Address - Country:US
Mailing Address - Phone:330-627-7611
Mailing Address - Fax:330-627-6773
Practice Address - Street 1:559 CANTON RD NW
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:44615-8426
Practice Address - Country:US
Practice Address - Phone:330-627-7611
Practice Address - Fax:330-627-6773
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH819111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0437950Medicaid
OH4038382Medicare PIN
OH0437950Medicaid