Individual
DR. CHARLES LESTER TALAN MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
520 PALM COAST PKWY SW, ST # 101, PALM COAST, FL 32137-4742
(386) 446-4107
(386) 447-2161
Mailing address
218 DONDANVILLE RD, SAINT AUGUSTINE, FL 32080-6405
(901) 581-8057
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT29295
FL
Other
Enumeration date
09/03/2014
Last updated
09/03/2014
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