Individual
MS. MELISSA LYNN MERTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
602 SW 38TH ST, LAWTON, OK 73505-6912
(580) 248-5780
Mailing address
1724 WHITE TAIL DR, ALTUS, OK 73521-7809
(405) 568-1831
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200381940B
—
OK
Enumeration date
06/27/2011
Last updated
05/12/2023
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