Individual
MITCHELL PRESTON KASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
201 CEDAR ST SE STE 7600, ALBUQUERQUE, NM 87106-4921
(505) 563-2500
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(504) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2022-0066
NM
Other
Enumeration date
12/22/2020
Last updated
09/23/2022
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