Provider Demographics
NPI:1710174768
Name:METTE, DON C (LMT,MTPT,SET)
Entity Type:Individual
Prefix:MR
First Name:DON
Middle Name:C
Last Name:METTE
Suffix:
Gender:M
Credentials:LMT,MTPT,SET
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2144 HOLLY OAKS RIVER DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-4885
Mailing Address - Country:US
Mailing Address - Phone:904-655-4965
Mailing Address - Fax:
Practice Address - Street 1:2144 HOLLY OAKS RIVER DR
Practice Address - Street 2:MOBILE PRACTICE
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225
Practice Address - Country:US
Practice Address - Phone:904-655-4965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA20212225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist