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General NPI Number Information
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NPI Number | 1326001546
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Entity Type | Individual
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Provider Name | JESSICA M MYERS DPT, MPH, CSCS,CMTPT
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Gender | Female
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 3510 ANDERSON HWY STE 2
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City | POWHATAN
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State | VA
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Zip | 23139-5846
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Country | US
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Telephone | 804-598-2100
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Fax | 804-598-7624
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Provider Business Mailing Address
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Address Line | PO BOX 69030
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City | BALTIMORE
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State | MD
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Zip | 21264-9030
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Country | US
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Telephone | 757-873-2302
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Fax | 757-873-2306
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305204405
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License Number State | VA
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