Provider Demographics
NPI:1609078757
Name:MERCURIO, FRANCIS ANTHONY (OTR)
Entity Type:Individual
Prefix:MR
First Name:FRANCIS
Middle Name:ANTHONY
Last Name:MERCURIO
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14001 SINGLELEAF LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278
Mailing Address - Country:US
Mailing Address - Phone:704-258-1821
Mailing Address - Fax:
Practice Address - Street 1:13104 WINTER HAZEL RD. APT 203
Practice Address - Street 2:APT 203
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278
Practice Address - Country:US
Practice Address - Phone:239-839-7291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3274225X00000X
NC6568225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist