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Individual
TIMOTHY W MITCHELL
Active
Individual
TIMOTHY W MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
002922
WV
225100000X
Physical Therapist
Primary
013103
OH
225100000X
Physical Therapist
PT021809
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT002922
WV LICENSE
—
01
—
PT013103
OHIO LICENSE
—
Enumeration date
12/17/2010
Last updated
03/02/2012
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