MEDICARE: LANDON MERCHANT DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	13942	TX

General Provider Information

NPI Number	:	1356913644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LANDON MERCHANT DC

Provider Business Mailing Address
First Line	:	4019 112TH ST
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79423-6749
Country	:	US
Telephone Number	:	806-542-1598
Fax Number	:

Provider Business Practice Location Address
First Line	:	4019 112TH ST
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79423-6749
Country	:	US
Telephone Number	:	806-542-1598
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2021
Last Update Date	:	07/15/2021

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Directions to “ LANDON MERCHANT DC” Practice Location

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