Healthcare Provider Details

I. General information

NPI: 1881217941
Provider Name (Legal Business Name): MERRIMAN PELVIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2020
Last Update Date: 05/24/2020
Certification Date: 05/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 OCEAN MIST CT
SAINT AUGUSTINE FL
32080-3101
US

IV. Provider business mailing address

507 OCEAN MIST CT
SAINT AUGUSTINE FL
32080-3101
US

V. Phone/Fax

Practice location:
  • Phone: 904-834-9955
  • Fax:
Mailing address:
  • Phone: 904-834-9955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CLAIRE FILLION MERRIMAN
Title or Position: OWNER
Credential: PT, DPT, MTC, PRPC
Phone: 904-834-9955