Provider Demographics
NPI:1891973749
Name:METZLER, EMERSON S (RPH)
Entity Type:Individual
Prefix:MR
First Name:EMERSON
Middle Name:S
Last Name:METZLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7448 STATE ROUTE 12
Mailing Address - Street 2:
Mailing Address - City:LOWVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13367-2815
Mailing Address - Country:US
Mailing Address - Phone:315-376-0333
Mailing Address - Fax:
Practice Address - Street 1:128 W MAIN ST
Practice Address - Street 2:BOLTON'S PHARMACY
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-1989
Practice Address - Country:US
Practice Address - Phone:315-782-5961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-02
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043863183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist