Individual
NATHAN MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
42644 COUNTY ROAD 653, PAW PAW, MI 49079-9471
(269) 312-9966
Mailing address
42644 COUNTY ROAD 653, PAW PAW, MI 49079-9471
(269) 312-9966
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7501000965
MI
Other
Enumeration date
08/27/2014
Last updated
08/27/2014
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