Individual
BROCK MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
710 S BUSINESS 61, BOWLING GREEN, MO 63334-5239
(573) 324-6079
Mailing address
53435 EAGLE RIDGE CT, NEW LONDON, MO 63459-2431
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
117923
MO
Other
Enumeration date
01/10/2007
Last updated
07/08/2007
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