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General NPI Number Information
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NPI Number | 1053373308
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Entity Type | Organization
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Legal Business Name | VICKI M MERRICK DC PA
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Dates
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Enumeration Date | 04/03/2006
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 2060 PALM BAY RD NE SUITE #2
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City | PALM BAY
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State | FL
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Zip | 32905-2931
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Country | US
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Telephone | 321-952-7004
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Fax | 321-952-1004
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Provider Business Mailing Address
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Address Line | PO BOX 100246
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City | PALM BAY
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State | FL
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Zip | 32910-0246
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Country | US
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Telephone | 321-952-7004
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Fax | 321-952-1004
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VICKI M MERRICK
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Credential | DC
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Telephone | 321-952-7004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH5958
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License Number State | FL
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