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NPI Code Detail

MEDICARE: DESTINY MYERS

MEDICARE: DESTINY MYERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist05015397AIN

General Provider Information

NPI Number : 1083481386
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESTINY MYERS
Provider Business Mailing Address
First Line : 33900 HARPER AVE STE 104
Second Line :
City : CLINTON TWP
State : MI
Zip : 48035-4258
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8628 PURDUE RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-1114
Country : US
Telephone Number : 317-677-0660
Fax Number : 317-677-0640
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2023
Last Update Date : 12/06/2023

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Directions to “ DESTINY MYERS ” Practice Location

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