Individual
TERRENCE RANDELL MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
HAIR LOSS SPECIALIST
Contact information
Practice address
1004 DYER ST, MALVERN, AR 72104-5255
(501) 732-6041
Mailing address
327 WOODLAND ST., MALVERN, AR 72104
(501) 732-6041
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
03/20/2020
Last updated
04/25/2022
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