Provider Demographics
NPI:1881217941
Name:MERRIMAN PELVIC HEALTH
Entity Type:Organization
Organization Name:MERRIMAN PELVIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:FILLION
Authorized Official - Last Name:MERRIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, MTC, PRPC
Authorized Official - Phone:904-834-9955
Mailing Address - Street 1:507 OCEAN MIST CT
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-3101
Mailing Address - Country:US
Mailing Address - Phone:904-834-9955
Mailing Address - Fax:
Practice Address - Street 1:507 OCEAN MIST CT
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-3101
Practice Address - Country:US
Practice Address - Phone:904-834-9955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-24
Last Update Date:2020-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy