Individual
JACK C METIVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6694 S M 88 HWY, BELLAIRE, MI 49615-9296
(616) 481-1947
Mailing address
6694 S M 88 HWY, BELLAIRE, MI 49615-9296
(616) 481-1947
Taxonomy
Speciality
Code
Description
License number
State
2279C0205X
Critical Care Registered Respiratory Therapist
Primary
95018
MI
Other
Enumeration date
12/08/2025
Last updated
12/08/2025
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