Individual
DR. GENNETTA GREER MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
5 LAKE CAROLINA WAY, COLUMBIA, SC 29229-7561
(803) 479-8400
(803) 477-3174
Mailing address
5 LAKE CAROLINA WAY, COLUMBIA, SC 29229
(803) 479-8400
(803) 477-3174
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X007213
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02009832
—
NY
01
—
X03631
BLUE CROSS/BLUE
NY
Enumeration date
11/01/2006
Last updated
01/25/2011
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