Provider Demographics
NPI:1396523973
Name:MERRITT, GRACE MARY (DPT)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:MARY
Last Name:MERRITT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:MERRITT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:GRACE MERRITT DPT
Mailing Address - Street 1:1030 FORREST AVE STE 105A
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3310
Mailing Address - Country:US
Mailing Address - Phone:302-268-8880
Mailing Address - Fax:
Practice Address - Street 1:1030 FORREST AVE STE 105A
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3310
Practice Address - Country:US
Practice Address - Phone:302-268-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist