Individual
MRS. JUANITA LYNN MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
508 3RD AVE, HEWITT, MN 56453-0015
(218) 924-4179
Mailing address
508 3RD AVE P.O.BOX 15, HEWITT, MN 56453-0015
(218) 924-4179
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
222078-2-AFC
MN
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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