Organization
MERRITT PHYSICAL THERAPY & REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA MOORE (ADMINISTRATOR)
(276) 935-6496
Entity
Organization
Contact information
Practice address
20716 RIVERSIDE DR, GRUNDY, VA 24614-6747
(276) 935-6496
(276) 935-5852
Mailing address
PO BOX 1078, GRUNDY, VA 24614-1078
(276) 935-6496
(276) 935-5852
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119003456
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004978471
—
VA
01
—
193488
ANTHEM OT
VA
Enumeration date
01/11/2007
Last updated
04/08/2015
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