Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT020229 | PA |
NPI | 1265768808 |
---|---|
Provider Name | Mr. Justin Meyers |
First Address | York, PA 17402-3650 |
Second Address | York, PA 17402-3650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2009 |
Last Update Date | 01/11/2009 |