Individual
AUSTIN MARK MIZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
7455 MORGAN RD, LIVERPOOL, NY 13090-3956
(315) 451-6767
Mailing address
113 CASTLE RD, NORTH SYRACUSE, NY 13212-2729
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
050001
NY
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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