James L Merrick, OT

Individual provider Active NPI Occupational Therapist · Shell Lake, WI

NPI 1285937151 · NPPES record last updated Dec 21, 2022

Key facts

NPI
1285937151
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
4048-26 (WI)
Practice address
113 4TH Avenue
Shell Lake, WI 54871
Phone
(715) 468-7833
Fax
(715) 468-7839
NPI assigned
Dec 14, 2010
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
4048-26WIMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 4048-26 WI Yes

Addresses

Primary practice location

113 4TH Avenue
Shell Lake, WI 54871

Mailing address

113 4TH Avenue
Shell Lake, WI 54871
Phone (715) 468-7833

Other providers in Shell Lake, WI

All providers in Shell Lake, WI · Occupational Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.