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Individual
STUART MIDTHUN MITCHELL
Active
Individual
STUART MIDTHUN MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12873-24
WI
225100000X
Physical Therapist
PT00008483
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0163023
DEPT OF LABOR & INDUSTRIE
WA
01
—
7483242
AETNA/LEXINGTON, KY
WA
01
—
810588134-01
KPS HEALTH PLANS
WA
01
—
9337MI
REGENCE BLUE SHIELD
WA
Enumeration date
05/24/2006
Last updated
07/21/2022
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