Individual
JOHNNY MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
162 SHADOW OAK LANE, FLIPPIN, AR 72634
(870) 404-2555
(870) 453-6558
Mailing address
126 SHADOW OAK LANE, FLIPPIN, AR 72634
(870) 404-2555
(870) 453-6558
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
26066
AR
Other
Enumeration date
11/10/2014
Last updated
11/10/2014
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