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General NPI Number Information
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NPI Number | 1841419769
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Entity Type | Individual
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Provider Name | MARY KAREN MERTZ MPT
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Gender | Female
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 06/24/2022
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Provider Practice Location Address
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Address Line | 39570 SPANISH OAKS DR
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City | TEMECULA
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State | CA
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Zip | 92592-8477
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Country | US
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Telephone | 951-314-4806
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Fax | 951-696-3808
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Provider Business Mailing Address
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Address Line | 39570 SPANISH OAKS DR
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City | TEMECULA
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State | CA
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Zip | 92592-8477
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Country | US
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Telephone | 951-314-4806
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 28751
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License Number State | CA
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