Individual
MRS. MELVA JO MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1515 NE LAWRIE TATUM RD, LAWTON, OK 73507-3002
(580) 354-5620
Mailing address
717 SW RANCH OAK BLVD, LAWTON, OK 73501-8229
(580) 354-5620
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
58329
OK
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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