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General NPI Number Information
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NPI Number | 1851106322
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Entity Type | Individual
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Provider Name | JOSIAH DANIEL MERCER PT, DPT, ATC/L
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Gender | Male
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 1100 WILFORD HALL LOOP
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City | LACKLAND AFB
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State | TX
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Zip | 78236-5638
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Country | US
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Telephone | 210-292-5040
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Fax |
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Provider Business Mailing Address
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Address Line | 2511 JUST MY STYLE
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City | SAN ANTONIO
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State | TX
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Zip | 78245-4647
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Country | US
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Telephone | 717-925-5817
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0126004228
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305216753
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License Number State | VA
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