Provider Demographics
NPI:1831115013
Name:MERRICK CENTER INC.
Entity Type:Organization
Organization Name:MERRICK CENTER INC.
Other - Org Name:MERRICK SPINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:HUMPHREY
Authorized Official - Last Name:MERRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC, PT
Authorized Official - Phone:603-641-4800
Mailing Address - Street 1:93 S MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-5749
Mailing Address - Country:US
Mailing Address - Phone:603-641-4800
Mailing Address - Fax:603-622-3199
Practice Address - Street 1:93 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-5749
Practice Address - Country:US
Practice Address - Phone:603-641-4800
Practice Address - Fax:603-622-3199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH112-0546-0183A111NI0900X
NH1088225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111NI0900XChiropractic ProvidersChiropractorInternistGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE3131Medicare ID - Type UnspecifiedMCARE GRP #