Provider Demographics
NPI:1811152622
Name:MEYERS, SCOTT (LMT)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:MEYERS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 HORTON DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4206
Mailing Address - Country:US
Mailing Address - Phone:631-425-1141
Mailing Address - Fax:
Practice Address - Street 1:80 HORTON DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-4206
Practice Address - Country:US
Practice Address - Phone:631-425-1141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005128172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist