Provider Demographics
NPI:1356563068
Name:MYERS, ERIC L (OTR,L)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:L
Last Name:MYERS
Suffix:
Gender:M
Credentials:OTR,L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 ELDON DR
Mailing Address - Street 2:
Mailing Address - City:WICKLIFFE
Mailing Address - State:OH
Mailing Address - Zip Code:44092-1535
Mailing Address - Country:US
Mailing Address - Phone:440-516-1536
Mailing Address - Fax:
Practice Address - Street 1:36855 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4128
Practice Address - Country:US
Practice Address - Phone:440-942-4342
Practice Address - Fax:440-942-4150
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT-004631225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist