Individual
CHARLES MERTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
13 HILLCREST DR, PONCA CITY, OK 74604-4808
(580) 765-1777
Mailing address
81 STONERIDGE RD, PONCA CITY, OK 74604-3418
(580) 762-2997
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0080905
OK
Other
Enumeration date
02/09/2009
Last updated
02/09/2009
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