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General NPI Number Information
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NPI Number | 1487860268
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Entity Type | Individual
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Provider Name | ROBERT CLARKSON MYERS II PT
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Gender | Male
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 216 E COMSTOCK ST STE C
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City | OWOSSO
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State | MI
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Zip | 48867-3161
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Country | US
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Telephone | 989-729-2929
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Fax | 989-729-6481
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Provider Business Mailing Address
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Address Line | 7495 BALDWIN RD
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City | SWARTZ CREEK
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State | MI
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Zip | 48473-9120
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Country | US
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Telephone | 989-271-1122
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Fax |
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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 | 5501009815
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License Number State | MI
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