Provider Demographics
NPI:1336465749
Name:METZLER, STEPHANIE JO (CMT, MMT-P)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:JO
Last Name:METZLER
Suffix:
Gender:F
Credentials:CMT, MMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7931 STATE HIGHWAY M123
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:MI
Mailing Address - Zip Code:49868-8133
Mailing Address - Country:US
Mailing Address - Phone:906-293-8714
Mailing Address - Fax:906-293-8714
Practice Address - Street 1:7931 STATE HIGHWAY M123
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:MI
Practice Address - Zip Code:49868-8133
Practice Address - Country:US
Practice Address - Phone:906-293-8714
Practice Address - Fax:906-293-8714
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRMT #3838172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist