Basic Information
| Provider Information | |||||||||
| NPI: | 1962713982 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | METOYER | ||||||||
| FirstName: | ALYCE | ||||||||
| MiddleName: | CARTER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 W HIGHAM ST | ||||||||
| Address2: | |||||||||
| City: | SAINT JOHNS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488791559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9892240646 | ||||||||
| FaxNumber: | 9892240929 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 W HIGHAM ST | ||||||||
| Address2: | |||||||||
| City: | SAINT JOHNS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488791559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9892240646 | ||||||||
| FaxNumber: | 9892240929 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2010 | ||||||||
| LastUpdateDate: | 08/13/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QA0505X | 5101015666 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine |
No ID Information.