Provider Demographics
NPI:1982170221
Name:MYERS, ROBY TAYLOR (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBY
Middle Name:TAYLOR
Last Name:MYERS
Suffix:
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 1:204 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLACKSTONE
Mailing Address - State:VA
Mailing Address - Zip Code:23824-1426
Mailing Address - Country:US
Mailing Address - Phone:434-298-0707
Mailing Address - Fax:434-298-0708
Practice Address - Street 1:204 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BLACKSTONE
Practice Address - State:VA
Practice Address - Zip Code:23824-1426
Practice Address - Country:US
Practice Address - Phone:434-298-0707
Practice Address - Fax:434-298-0708
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-14
Last Update Date:2018-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104-557517111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician