Provider Demographics
NPI:1720520935
Name:MYERS PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:MYERS PHYSICAL THERAPY, LLC
Other - Org Name:MYERS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:907-374-0225
Mailing Address - Street 1:418 3RD ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-3585
Mailing Address - Country:US
Mailing Address - Phone:907-374-0225
Mailing Address - Fax:907-308-4025
Practice Address - Street 1:418 3RD ST STE 1B
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-3585
Practice Address - Country:US
Practice Address - Phone:907-374-0225
Practice Address - Fax:907-308-4025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty