Individual
MR. STEVEN GLEN METTERNICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05001152A
IN
225100000X
Physical Therapist
070002318
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000-1232012
BLUE CROSS-KINTIC-INDIVIDUAL
IL
01
—
0001283001
BLUE CROSS BLUE SHIELD
IL
01
—
001541
HEALTH ALLIANCE
IL
01
—
010934666
KINETIC TAX ID
IL
01
—
1232012
BLUE CROSS 2010 KINETIC
IL
01
—
356107600
US DEPT OF LABOR
IL
01
—
650005686
RAILROAD MEDICARE UPIN
IL
Enumeration date
07/28/2006
Last updated
11/02/2012
Update your record
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