Healthcare Provider Details

I. General information

NPI: 1538081674
Provider Name (Legal Business Name): MERION SQUARE ROAD MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 S MAIN ST STE 435
DAYTON OH
45402-2070
US

IV. Provider business mailing address

31 S MAIN ST STE 435
DAYTON OH
45402-2070
US

V. Phone/Fax

Practice location:
  • Phone: 646-598-8338
  • Fax: 866-301-4910
Mailing address:
  • Phone: 646-598-8338
  • Fax: 866-301-4910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: RONALD DIXON
Title or Position: PRESIDENT & CEO
Credential: MD
Phone: 617-312-6914