Individual
WAYNE JOSEPH MITCHELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTA
Contact information
Practice address
268 W SAUGERTIES RD, SAUGERTIES, NY 12477-3142
(845) 247-8777
Mailing address
PO BOX 528, GLASCO, NY 12432-0528
(845) 532-4483
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007390-1
NY
Other
Enumeration date
02/04/2011
Last updated
02/04/2011
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