Organization
MARK G. MITCHELL, OD, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK GLENN MITCHELL O.D. (CEO)
(775) 825-0506
Entity
Organization
Contact information
Practice address
4600 KIETZKE LN, B-119, RENO, NV 89502-5033
(775) 825-0506
(775) 825-0873
Mailing address
4600 KIETZKE LN, B-119, RENO, NV 89502-5033
(775) 825-0506
(775) 825-0873
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
374
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V28949
PTAN
—
Enumeration date
05/01/2007
Last updated
10/09/2013
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