Individual
KAMERON MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
5505 COVENTRY LN, FORT WAYNE, IN 46804-7144
(317) 522-6380
Mailing address
3236 COPPER HILL RUN, FORT WAYNE, IN 46804-3425
(320) 333-6389
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
11/19/2024
Last updated
11/19/2024
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