| NPI | 1497295026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYRI MERRILL Sole Practitioner 618-444-2846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070016066) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |