Individual
RYAN MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3058 N STATE RD STE E, DAVISON, MI 48423-3508
(810) 652-6315
(810) 652-6213
Mailing address
5825 MILL ST, CLARKSTON, MI 48346-3363
(810) 282-1345
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502005419
MI
2255A2300X
Athletic Trainer
12089
MI
Other
Enumeration date
02/11/2021
Last updated
03/05/2021
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