Organization
MERRILL ENTERPRISES, INC
Active
Organization
MERRILL ENTERPRISES, INC
Active
Other names
Prescott Pediatric Occupational Therapy; Second Sight Vision Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE MERRILL OTR/L (OWNER / SECRETARY)
(928) 771-2406
Entity
Organization
Contact information
Practice address
340 N MOUNT VERNON AVE, PRESCOTT, AZ 86301-2620
(928) 771-2406
(928) 771-9519
Mailing address
512 W LEROUX ST, PRESCOTT, AZ 86303-4126
(928) 771-2406
(928) 771-9017
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0006
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
770629
AHCCCS #
AZ
01
—
AZ0295630
BLUE CROSS #
AZ
Enumeration date
05/03/2006
Last updated
08/22/2020
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