Provider Demographics
NPI:1245259688
Name:MYERS, ROBERT R (PT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:R
Last Name:MYERS
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:16 WEST ST
Mailing Address - Street 2:
Mailing Address - City:WEST HATFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01088-9515
Mailing Address - Country:US
Mailing Address - Phone:413-247-6471
Mailing Address - Fax:413-247-6474
Practice Address - Street 1:16 WEST ST
Practice Address - Street 2:
Practice Address - City:WEST HATFIELD
Practice Address - State:MA
Practice Address - Zip Code:01088
Practice Address - Country:US
Practice Address - Phone:413-247-6471
Practice Address - Fax:413-247-6474
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA5364225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA465532OtherTUFTS
650018717OtherRAILROAD MEDICARE
MA626519OtherHARVARD PILGRIM
MAY66164OtherBCBS OF MASSACHUSETTS
MA788816OtherCONNECTICARE
MA626519OtherHARVARD PILGRIM