Healthcare Provider Details

I. General information

NPI: 1407372253
Provider Name (Legal Business Name): WILLIAM MYERS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2017
Last Update Date: 08/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1929 E WASHINGTON ST
NEW CASTLE PA
16101-5236
US

IV. Provider business mailing address

1929 E WASHINGTON ST
NEW CASTLE PA
16101-5236
US

V. Phone/Fax

Practice location:
  • Phone: 17246549841
  • Fax:
Mailing address:
  • Phone: 17246549841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: