Individual
MITCHELL ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
11104 Y ST, OMAHA, NE 68137-4670
(405) 490-8677
Mailing address
11104 Y ST, OMAHA, NE 68137-4670
(402) 490-8677
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
943
NE
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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