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General NPI Number Information
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NPI Number | 1952186306
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Entity Type | Individual
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Provider Name | TARA ANN MERRILL MS, CPO
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Gender | Female
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Dates
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Enumeration Date | 08/25/2023
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 1409 YANCEYVILLE STREET SUITE B
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City | GREENSBORO
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State | NC
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Zip | 27405-6961
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Country | US
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Telephone | 336-537-3901
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Fax | 336-893-9537
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Provider Business Mailing Address
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Address Line | 1345 WESTGATE CENTER DRIVE SUITE B
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City | WINSTON SALEM
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State | NC
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Zip | 27103-3041
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Country | US
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Telephone | 336-546-7165
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Fax | 866-403-2483
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Authorized Official
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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Taxonomy #2
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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