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Individual

MICHAEL MITCHELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1716 GALLATIN PIKE N, MADISON, TN 37115-2122
(615) 868-9877
(618) 868-9892
Mailing address
1716 GALLATIN PIKE N, MADISON, TN 37115-2122
(615) 868-9877
(618) 868-9892

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
0000000826
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000826
STATE OF TENNESSEE DISPENSER LICENSE
TN
Enumeration date
08/13/2014
Last updated
08/13/2014
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