Individual
MRS. ELIZABETH MARY MYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
385 VISTA ROMA WAY #302, SAN JOSE, CA 95136
(925) 788-2214
Mailing address
385 VISTA ROMA WAY #302, SAN JOSE, CA 95136
(925) 788-2214
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
PROVIDER CODE 22
CA
Enumeration date
08/05/2014
Last updated
08/05/2014
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