Provider Demographics
NPI:1760544944
Name:HAMILTON, MERRY LYNNE (PT, PHD)
Entity Type:Individual
Prefix:DR
First Name:MERRY
Middle Name:LYNNE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:PT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-7622
Mailing Address - Country:US
Mailing Address - Phone:713-530-8324
Mailing Address - Fax:
Practice Address - Street 1:720 15TH ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-7622
Practice Address - Country:US
Practice Address - Phone:713-530-8324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12912251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics