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General NPI Number Information
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NPI Number | 1891228672
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Entity Type | Individual
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Provider Name | CORY JOSEPH MYERS D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 100 N ACADEMY AVE
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City | DANVILLE
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State | PA
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Zip | 17822-2113
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Country | US
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Telephone | 570-214-2261
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Fax |
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Provider Business Mailing Address
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Address Line | 100 NORTH ACADEMY AVE 14-03 NEUROLOGY
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City | DANVILLE
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State | PA
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Zip | 17822
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Country | US
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Telephone | 570-214-2261
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | OS023024
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License Number State | PA
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