Individual
MITCHELL TODD BODIFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 S J ST, LAKEVIEW, OR 97630-1623
(541) 947-2114
Mailing address
700 S J ST, LAKEVIEW, OR 97630-1623
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15287
TN
225100000X
Physical Therapist
64939
OR
Other
Enumeration date
06/05/2023
Last updated
01/30/2026
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