Individual
MRS. JESSICA M MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, MPH, CSCS,CMTPT
Contact information
Practice address
3510 ANDERSON HWY STE 2, POWHATAN, VA 23139-5846
(804) 598-2100
(804) 598-7624
Mailing address
PO BOX 69030, BALTIMORE, MD 21264-9030
(757) 873-2302
(757) 873-2306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305204405
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326001546
—
VA
01
—
225579
BCBS (PHYSICAL THERAPY)
VA
01
—
7966743
AETNA
VA
01
—
P00457792
RAILROAD MEDICARE
VA
Enumeration date
04/10/2006
Last updated
04/30/2018
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