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Individual

MICHAEL MERTEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, ATC,

Contact information

Practice address
3101 MADISON AVE, GRANITE CITY, IL 62040-3620
(618) 451-5808
(618) 451-6296
Mailing address
203 ECHOWOOD DR, COLLINSVILLE, IL 62234-7107
(618) 570-8434
(618) 451-6296

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096000293
IL

Other

Enumeration date
05/24/2016
Last updated
05/24/2016
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