Individual
MYIA MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6012 W. NORTH AVENUE, MILWAUKEE, WI 53213
(414) 807-9555
Mailing address
PO BOX 100144, MILWAUKEE, WI 53210-0144
(414) 807-9555
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7296-085
WI
Other
Enumeration date
07/23/2015
Last updated
07/23/2015
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