Individual
MR. MATTHEW JOHN MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
138 BURNINGTREE DR, GROTON, CT 06340-3100
(910) 333-4110
Mailing address
138 BURNINGTREE DR, GROTON, CT 06340-3100
(910) 333-4110
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/07/2011
Last updated
05/07/2011
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