Provider Demographics
NPI:1124507538
Name:MYERS, JAMES HILARY (DPT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:HILARY
Last Name:MYERS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 BRADFORD BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:GORDONSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38563-4618
Mailing Address - Country:US
Mailing Address - Phone:615-683-3010
Mailing Address - Fax:615-683-3016
Practice Address - Street 1:482 INTERSTATE DR STE H
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-3486
Practice Address - Country:US
Practice Address - Phone:931-954-1060
Practice Address - Fax:931-954-5944
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11894225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist