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General NPI Number Information
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NPI Number | 1467274829
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Entity Type | Individual
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Provider Name | JON MERRITT
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Gender | Male
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 625 ROCKLAND ST STE 2
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City | ROCKPORT
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State | ME
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Zip | 04856-5387
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Country | US
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Telephone | 207-230-1113
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Fax | 207-230-1113
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Provider Business Mailing Address
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Address Line | 81 VINAL ST
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City | ROCKPORT
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State | ME
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Zip | 04856-4825
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Country | US
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Telephone | 207-691-1732
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Fax |
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | DL483
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License Number State | ME
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