Individual
MICHAEL JOSEPH MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
321 6TH ST NE, CHISHOLM, MN 55719-1287
(218) 274-7712
(218) 254-9968
Mailing address
309 WASHINGTON AVE, ORTONVILLE, MN 56278-1357
(320) 839-4090
(320) 839-4196
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1969
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1969
STATE LICENSE FOR PT
ND
Enumeration date
06/20/2017
Last updated
06/20/2017
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