Provider Demographics
NPI:1447453261
Name:MERCK, AUSTIN BRIAN (PT)
Entity type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:BRIAN
Last Name:MERCK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 BENSON DR
Mailing Address - Street 2:STE 135A
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7362
Mailing Address - Country:US
Mailing Address - Phone:919-872-8511
Mailing Address - Fax:919-872-8557
Practice Address - Street 1:3301 BENSON DR
Practice Address - Street 2:STE 135A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7362
Practice Address - Country:US
Practice Address - Phone:919-872-8511
Practice Address - Fax:919-872-8557
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7893225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist