Provider Demographics
NPI:1477830727
Name:MERRITT, LEVI G (DC)
Entity Type:Individual
Prefix:DR
First Name:LEVI
Middle Name:G
Last Name:MERRITT
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 1:100 ERSKINE LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:SCOTT DEPOT
Mailing Address - State:WV
Mailing Address - Zip Code:25560-9751
Mailing Address - Country:US
Mailing Address - Phone:304-757-7246
Mailing Address - Fax:304-757-7245
Practice Address - Street 1:100 ERSKINE LN
Practice Address - Street 2:SUITE B
Practice Address - City:SCOTT DEPOT
Practice Address - State:WV
Practice Address - Zip Code:25560-9751
Practice Address - Country:US
Practice Address - Phone:304-757-7246
Practice Address - Fax:304-757-7245
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV922111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor