Provider Demographics
NPI:1366752123
Name:MESSER, ERIC
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:MESSER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 HIGHWAY 31 S
Mailing Address - Street 2:
Mailing Address - City:HENRYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47126-9777
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:413 HIGHWAY 31 S
Practice Address - Street 2:
Practice Address - City:HENRYVILLE
Practice Address - State:IN
Practice Address - Zip Code:47126-9777
Practice Address - Country:US
Practice Address - Phone:606-233-2617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06004123A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant