Healthcare Provider Details

I. General information

NPI: 1437073178
Provider Name (Legal Business Name): JAKOB MYERS DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4859 NIXON PARK DR
MASON OH
45040-8106
US

IV. Provider business mailing address

6480 HARRISON AVE STE 201
CINCINNATI OH
45247-7961
US

V. Phone/Fax

Practice location:
  • Phone: 513-354-3700
  • Fax: 513-354-7651
Mailing address:
  • Phone: 205-545-2717
  • Fax: 513-354-7651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT022555
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: