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General NPI Number Information
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NPI Number | 1518236462
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Entity Type | Organization
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Legal Business Name | OLYMPIC HEALTH AND SPORTS THERAPY PC
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Dates
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Enumeration Date | 12/21/2011
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 2440 WHITNEY AVE # 209
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City | HAMDEN
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State | CT
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Zip | 06518-3222
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Country | US
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Telephone | 203-287-8524
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Fax | 203-287-2452
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Provider Business Mailing Address
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Address Line | 2440 WHITNEY AVE # 209
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City | HAMDEN
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State | CT
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Zip | 06518-3222
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Country | US
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Telephone | 203-287-8524
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Fax | 203-287-2452
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Authorized Official
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Title or Position | OWNER
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Name | DR. ERIC DOUGLAS MEYERS
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Credential | D.C.
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Telephone | 203-287-8524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 001630
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License Number State | CT
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