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General NPI Number Information
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NPI Number | 1013890342
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Entity Type | Individual
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Provider Name | ADRIENNE VICTORIA MERRICK
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Gender | Female
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 32 CAMPUS DR
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City | MISSOULA
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State | MT
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Zip | 59812-0004
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Country | US
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Telephone | 307-871-8548
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Fax |
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Provider Business Mailing Address
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Address Line | 1325 DOE DR
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City | GREEN RIVER
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State | WY
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Zip | 82935-6602
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Country | US
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Telephone | 307-871-8548
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Fax | 307-871-8548
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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