Individual
KENNETH RAY MITCHELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
COMDT CG-1122 U S COAST GUARD, 2100 2ND ST SW, SUITE 5314, WASHINGTON, DC 20593-0001
(757) 856-2230
Mailing address
COMDT CG-1122 U S COAST GUARD, 2100 2ND ST SW, SUITE 5314, WASHINGTON, DC 20593-0001
(757) 856-2230
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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