Individual
JEREMY MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
805 E WALNUT AVE, LOMPOC, CA 93436-7027
(805) 735-3714
Mailing address
259 RIVERDALE CT APT 236, CAMARILLO, CA 93012-7775
(805) 478-7263
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
10986PT
AZ
Other
Enumeration date
08/19/2014
Last updated
11/19/2014
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