Individual
JUSTIN DOUGLAS MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1393 CELANESE RD, ROCK HILL, SC 29732-1722
(803) 329-3103
(803) 325-2232
Mailing address
1393 CELANESE RD, ROCK HILL, SC 29732-1722
(803) 329-3103
(803) 325-2232
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3834
SC
225100000X
Physical Therapist
6620
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0788C
BLUE CROSS BLUE SHIELD NC
NC
01
—
E1570
MEDCOST
—
Enumeration date
03/23/2006
Last updated
03/04/2016
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