Individual
NICHOLAS MYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
9700 STONESTREET RD, LOUISVILLE, KY 40272-2884
(502) 995-6600
Mailing address
8616 STANDING OAK DR APT 3, LOUISVILLE, KY 40258-1288
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
170476
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170476
—
KY
Enumeration date
08/08/2017
Last updated
08/08/2017
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