Individual
KEITH WILLIAM MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1467 N MACK SMITH RD, EAST RIDGE, TN 37412-3947
(423) 894-4403
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
PTA002272
GA
225200000X
Physical Therapy Assistant
Primary
PTA3594
TN
Other
Enumeration date
08/01/2011
Last updated
08/01/2011
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