Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1245451 | TX |
N | 225100000X | Physical Therapist | 21416 | MA |
N | 225100000X | Physical Therapist | 2305208278 | VA |
N | 225100000X | Physical Therapist | PT871541 | DC |
NPI | 1003213984 |
---|---|
Provider Name | Rachael Lynne Mervine |
First Address | Houston, TX 77004-7140 |
Second Address | Houston, TX 77004-7140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2014 |
Last Update Date | 20/11/2014 |