Individual
MATTHEW D MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
1069 US HIGHWAY 224, NOVA, OH 44859-9770
(419) 652-2219
(419) 652-2219
Mailing address
1069 US HIGHWAY 224, NOVA, OH 44859-9770
(419) 652-2219
(419) 652-2219
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT004389
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000325537
ANTHEM BLUE CROSS
OH
Enumeration date
01/23/2006
Last updated
07/08/2007
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