Individual
MITCHELL DOUGLAS GILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
123 BROAD ST, DACULA, GA 30019-2139
(404) 625-0285
Mailing address
1348 ROLLING STREAM WAY, LAWRENCEVILLE, GA 30043-3862
(404) 625-0285
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001510
GA
Other
Enumeration date
03/07/2019
Last updated
03/07/2019
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