Individual
JORDAN MERTGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHA, MLS(ASCP)CM
Contact information
Practice address
1728 JESSE JAMES CT, BOONVILLE, MO 65233-2874
(816) 416-6142
Mailing address
1728 JESSE JAMES CT, BOONVILLE, MO 65233-2874
(816) 416-6142
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
S081304001
MO
Other
Enumeration date
12/01/2023
Last updated
12/01/2023
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