Individual
JACQUELINE MERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
21314 SELWYN AVE, CARSON, CA 90745-2239
(310) 540-7676
Mailing address
21314 SELWYN AVE, CARSON, CA 90745-2239
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT12896
CA
Other
Enumeration date
06/07/2016
Last updated
06/07/2016
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