Individual
KEITH LASHAWN MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2437 LAKE VISTA CT APT 307, CASSELBERRY, FL 32707-6470
(407) 308-2893
Mailing address
2437 LAKE VISTA CT APT 307, CASSELBERRY, FL 32707-6470
(407) 308-2893
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA77421
FL
Other
Enumeration date
09/26/2020
Last updated
09/26/2020
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