Individual
MARK ANTHONY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
1140 KELLUM LOOP RD, #36, JACKSONVILLE, NC 28546-3321
(917) 603-6469
Mailing address
1140 KELLUM LOOP RD, #36, JACKSONVILLE, NC 28546-3321
(917) 603-6469
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/31/2007
Last updated
07/31/2007
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