Provider Demographics
NPI:1487720850
Name:MYERS, ERIKA DAWN (MPT)
Entity type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:DAWN
Last Name:MYERS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MS
Other - First Name:ERIKA
Other - Middle Name:DAWN
Other - Last Name:ELLIFRITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 S PRICE ST
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26537-1442
Mailing Address - Country:US
Mailing Address - Phone:304-329-1400
Mailing Address - Fax:304-329-1175
Practice Address - Street 1:165 PLAZA CT
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:WV
Practice Address - Zip Code:26537-1653
Practice Address - Country:US
Practice Address - Phone:304-329-3908
Practice Address - Fax:304-329-3918
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2508225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV511312Medicare ID - Type Unspecified