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Individual

MERRILL L LEMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1400 SHELBY DR, DYERSBURG, TN 38024-3435
(731) 288-5056
(731) 288-5067
Mailing address
1400 SHELBY DR, DYERSBURG, TN 38024-3435
(731) 288-5056
(731) 288-5067

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000001167
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1510384
TN
01
4180906
BLUE CROSS BLUE SHIELD
TN
Enumeration date
02/28/2008
Last updated
12/18/2013
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