Organization
MERRITT PHYSICAL THERAPY & REHABILIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA MOORE (LPTA/ADMINISTRATOR)
(276) 935-6496
Entity
Organization
Contact information
Practice address
20716 RIVERSIDE DR, GRUNDY, VA 24614-6747
(276) 935-6496
Mailing address
PO BOX 1078, GRUNDY, VA 24614-1078
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202005875
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184774598
—
VA
Enumeration date
06/06/2013
Last updated
04/08/2015
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