Provider Demographics
NPI:1841947660
Name:METZLER, TODD EDWARD (LMT)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:EDWARD
Last Name:METZLER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4353 W TYLER RD
Mailing Address - Street 2:
Mailing Address - City:HART
Mailing Address - State:MI
Mailing Address - Zip Code:49420-8212
Mailing Address - Country:US
Mailing Address - Phone:231-873-3625
Mailing Address - Fax:
Practice Address - Street 1:4353 W TYLER RD
Practice Address - Street 2:
Practice Address - City:HART
Practice Address - State:MI
Practice Address - Zip Code:49420-8212
Practice Address - Country:US
Practice Address - Phone:231-437-0396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501000145225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty