Individual
JEREMY TULLEDGE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
171 NORWICH AVE, COLCHESTER, CT 06415-1274
(860) 537-3014
(860) 537-1420
Mailing address
PO BOX 267, COLCHESTER, CT 06415-0267
(860) 537-3014
(860) 537-1420
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
13372
CT
Other
Enumeration date
12/17/2021
Last updated
12/17/2021
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