Individual
GWENDOLYN MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
3962 75TH ST W APT 702, BRADENTON, FL 34209-5820
(941) 224-1142
Mailing address
3962 75TH ST W APT 702, BRADENTON, FL 34209-5820
(941) 224-1142
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA49291
FL
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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