Provider Demographics
NPI:1215142054
Name:MEYER, TY CHRISTOPHER (PT)
Entity type:Individual
Prefix:MR
First Name:TY
Middle Name:CHRISTOPHER
Last Name:MEYER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44654-9497
Mailing Address - Country:US
Mailing Address - Phone:330-231-2953
Mailing Address - Fax:
Practice Address - Street 1:1207 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:OH
Practice Address - Zip Code:44654-9497
Practice Address - Country:US
Practice Address - Phone:330-600-0844
Practice Address - Fax:330-674-0717
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT005846225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist