Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 2013013303 | MO |
NPI | 1124467758 |
---|---|
Provider Name | Tristin E Mette |
First Address | Blue Springs, MO 64015-7029 |
Second Address | Lees Summit, MO 64081-3284 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2013 |
Last Update Date | 17/06/2013 |