Individual
BRANDY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1608 WEBSTER STREET, PHILADELPHIA, PA 19146
(570) 847-9263
Mailing address
1608 WEBSTER STREET, PHILADELPHIA, PA 19146
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OC013315
PA
Other
Enumeration date
12/01/2014
Last updated
12/01/2014
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