Provider Demographics
NPI:1467626887
Name:MERRION, RICHARD MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MATTHEW
Last Name:MERRION
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 1:2690 RESEARCH PARK DR STE A
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-4921
Mailing Address - Country:US
Mailing Address - Phone:630-442-9697
Mailing Address - Fax:
Practice Address - Street 1:2690 RESEARCH PARK DR STE A
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-4921
Practice Address - Country:US
Practice Address - Phone:630-442-9697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5254-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor