Individual
MR. JORDAN ISAAC MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1525 CUBA RD, MAYFIELD, KY 42066-6809
(270) 247-2588
Mailing address
1525 CUBA RD, MAYFIELD, KY 42066-6809
(270) 247-2588
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/17/2016
Last updated
11/17/2016
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