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Jacqueline M Myers

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NPI Number Detailed Information

Provider Information:

Name: Jacqueline M Myers
Gender: F
Provider License Number If Given: 0337916-21

NPI Information:

NPI: 1942203997
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 10/6/2016

Provider Business Mailing Address:

Address: 1153 E MAIN ST PO BOX 2563
Lancaster, OH 43130
Phone Number: 7406878990
Fax Number: 7406878230

Provider Business Practice Location Address:

Address: 618 PLEASANTVILLE RD SUITE 202
Lancaster, OH 43130
Phone Number: 7406819020
Fax Number: 7406819112

Provider Taxonomy:

Primary: 363L00000X
Secondary (if any): 363LA2200X
State: OH

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