Individual
MS. ANDREA GRACE MITCHELL SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
45 SEEKONK ST, PROVIDENCE, RI 02906-5125
(401) 230-1126
Mailing address
124 LOWDEN ST, PAWTUCKET, RI 02860-6045
(401) 439-1668
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT01666
RI
2251X0800X
Orthopedic Physical Therapist
PT01666
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27943-1
BCBS
RI
01
—
411986
BCHIP
RI
Enumeration date
06/09/2006
Last updated
01/11/2008
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