Provider Demographics
NPI:1720454606
Name:MERRYMAN, LINDSEY (PT, DPT, SCS, AT)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:MERRYMAN
Suffix:
Gender:F
Credentials:PT, DPT, SCS, AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 ATHLETICS CENTER
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74078-0001
Mailing Address - Country:US
Mailing Address - Phone:405-744-2112
Mailing Address - Fax:405-744-4945
Practice Address - Street 1:170 ATHLETICS CENTER
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74078-1397
Practice Address - Country:US
Practice Address - Phone:405-744-2112
Practice Address - Fax:405-744-4945
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.016001225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH415300OtherMEDICARE PTAN