Individual
GARY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
100 EASTSIDE DR, GEORGETOWN, KY 40324-9797
(502) 868-0097
(502) 868-7499
Mailing address
100 EASTSIDE DR, GEORGETOWN, KY 40324-9797
(502) 868-0097
(502) 868-7499
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
249455
KY
111N00000X
Chiropractor
5314
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100313440
—
KY
Enumeration date
03/22/2012
Last updated
01/10/2020
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