Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | ||
N | 225000000X | Orthotic Fitter |
NPI | 1770938946 |
---|---|
Provider Name | Mr. Lorin Christopher Merkley |
First Address | Gilbert, AZ 85297-7490 |
Second Address | Mesa, AZ 85212-3627 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2016 |
Last Update Date | 27/01/2017 |