Provider Demographics
NPI:1942457650
Name:MERRIMAN, MICHAEL FREDERICK (DPT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:FREDERICK
Last Name:MERRIMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5514 NIKE DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9081
Mailing Address - Country:US
Mailing Address - Phone:614-529-8733
Mailing Address - Fax:
Practice Address - Street 1:5130 BRADENTON AVE
Practice Address - Street 2:STE B
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-7557
Practice Address - Country:US
Practice Address - Phone:614-336-8733
Practice Address - Fax:614-336-0658
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.012163225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist