MEDICARE: RICHARD W MERRITT DC PA

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	CH2541	FL

General Provider Information

NPI Number	:	1851398705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD W MERRITT DC PA

Provider Business Mailing Address
First Line	:	1253 W MEMORIAL BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33815-0602
Country	:	US
Telephone Number	:	863-687-8165
Fax Number	:	863-687-1807

Provider Business Practice Location Address
First Line	:	1253 W MEMORIAL BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33815-0602
Country	:	US
Telephone Number	:	863-687-8165
Fax Number	:	863-687-1807

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD W MERRITT
Credential	:	D.C.
Telephone Number	:	863-687-8165

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	03/29/2012

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