Healthcare Provider Details

I. General information

NPI: 1235415399
Provider Name (Legal Business Name): JAMES MYERS M.S., D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2011
Last Update Date: 01/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 CARPENTER DR NE SUITE 209
SANDY SPRINGS GA
30328-4928
US

IV. Provider business mailing address

275 CARPENTER DR NE SUITE 209
SANDY SPRINGS GA
30328-4928
US

V. Phone/Fax

Practice location:
  • Phone: 404-255-4410
  • Fax: 404-781-4410
Mailing address:
  • Phone: 404-255-4410
  • Fax: 404-781-4410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4040
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR008917
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: