Provider Demographics
NPI:1699855379
Name:MYERS, KEVIN RICHARD (DC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:RICHARD
Last Name:MYERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3244 WASHINGTON RD STE 205
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3153
Mailing Address - Country:US
Mailing Address - Phone:724-942-3505
Mailing Address - Fax:
Practice Address - Street 1:3244 WASHINGTON RD STE 205
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3153
Practice Address - Country:US
Practice Address - Phone:724-344-6993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005683L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA201944OtherUPMC
PA667067OtherUNITED HEALTHCARE
PA610238400OtherDEPT OF LABOR
PA757552OtherBC/BS
PA3522930OtherAETNA
PA757552Medicare ID - Type Unspecified