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General NPI Number Information
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NPI Number | 1821598533
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Entity Type | Individual
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Provider Name | CHRISTINE ANN MERRILL LMT NCBTMB
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Gender | Female
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Dates
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Enumeration Date | 02/19/2018
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 5701 CHEROKEE DRAW RD
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City | AUSTIN
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State | TX
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Zip | 78738-4066
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Country | US
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Telephone | 630-750-6238
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Fax | 512-828-7441
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Provider Business Mailing Address
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Address Line | 5701 CHEROKEE DRAW RD
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City | AUSTIN
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State | TX
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Zip | 78738-4066
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Country | US
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Telephone | 630-750-6238
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Fax | 512-828-7441
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT120234
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License Number State | TX
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