Provider Demographics
NPI:1366414450
Name:MERRITT, LISA ANN (DC, NMD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANN
Last Name:MERRITT
Suffix:
Gender:F
Credentials:DC, NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13655 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:WEDDINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28104-9373
Mailing Address - Country:US
Mailing Address - Phone:704-847-7200
Mailing Address - Fax:704-845-9379
Practice Address - Street 1:13655 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:WEDDINGTON
Practice Address - State:NC
Practice Address - Zip Code:28104-9373
Practice Address - Country:US
Practice Address - Phone:704-847-7200
Practice Address - Fax:704-845-9379
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200001236824111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition