Individual
MS. STACIA ANN MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3101 N FLORIDA AVE, ALAMOGORDO, NM 88310-9713
(575) 434-0033
Mailing address
301 PANORAMA BLVD APT 705, ALAMOGORDO, NM 88310-7277
(620) 617-4914
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-0668
NM
Other
Enumeration date
07/29/2009
Last updated
07/29/2009
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