Individual
JACK MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
919 LAWRENCE, DETROIT, MI 48202
(313) 418-2808
Mailing address
919 LAWRENCE ST, DETROIT, MI 48202-1046
(313) 418-2808
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
07/25/2017
Last updated
07/21/2022
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