Individual
MR. MITCHELL DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111312 VILLAGE RD, CHASKA, MN 55318-1385
(650) 321-9999
Mailing address
111312 VILLAGE RD, CHASKA, MN 55318-1385
(952) 221-2237
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
Q307148741310
CA
Other
Enumeration date
05/04/2014
Last updated
05/04/2014
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