Provider Demographics
NPI:1861782815
Name:METTE, JEFF COLIN (LMT)
Entity type:Individual
Prefix:MR
First Name:JEFF
Middle Name:COLIN
Last Name:METTE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7925 MERRILL RD
Mailing Address - Street 2:#2016
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-3774
Mailing Address - Country:US
Mailing Address - Phone:904-607-7808
Mailing Address - Fax:
Practice Address - Street 1:368 OSCEOLA AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-4056
Practice Address - Country:US
Practice Address - Phone:904-607-7808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA13513225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist