Individual
DALLES S MERRIMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1010 STE GENEVIEVE DR, STE GENEVIEVE, MO 63670-1447
(573) 883-5725
Mailing address
12714 TALL PINE DR, STE GENEVIEVE, MO 63670-8622
(573) 535-0745
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2001028596
MO
Other
Enumeration date
05/25/2022
Last updated
05/25/2022
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