Individual
MR. JIMMIE MITCHELL III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3926 HUMBOLDT ST, DETROIT, MI 48208-2519
(313) 603-6235
Mailing address
3926 HUMBOLDT ST, DETROIT, MI 48208-2519
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501000837
MI
Other
Enumeration date
01/17/2017
Last updated
01/17/2017
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