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Individual

MRS. JOANN DAWN MIX

Active
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Individual

MRS. JOANN DAWN MIX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070018003
IL
225100000X
Physical Therapist
Primary
11-05712
KS
225100000X
Physical Therapist
2010006857
MO
225100000X
Physical Therapist
40574
CA
225100000X
Physical Therapist
40QA00986500
NJ
225100000X
Physical Therapist
PT-3992
HI
225100000X
Physical Therapist
PT011528
GA
225100000X
Physical Therapist
PTH7173
AL

Other

Enumeration date
09/11/2012
Last updated
04/02/2018
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