Individual
MAX MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
112 W 770 N, SANTAQUIN, UT 84655-7913
(801) 754-3654
Mailing address
112 W 770 N, SANTAQUIN, UT 84655-7913
(801) 754-3654
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3102637-4405
UT
Other
Enumeration date
10/26/2015
Last updated
09/29/2021
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