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Individual

MICHELLE MITCHUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSCJ/L, CHW, CPT, LC

Contact information

Practice address
4631 SAVANNAH HWY, NORTH, SC 29112-8180
(803) 247-2534
Mailing address
4055 COBURG LN, ORANGEBURG, SC 29115-9014
(803) 662-3377

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
246RP1900X
Phlebotomy Technician

Other

Enumeration date
12/30/2020
Last updated
12/30/2020
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