Individual
JACK MIXNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
1706 E SEMORAN BLVD STE 107, APOPKA, FL 32703-5610
(407) 880-7772
Mailing address
1788 HEMPEL AVE, WINDERMERE, FL 34786-8118
(407) 808-3068
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
5095
FL
Other
Enumeration date
06/08/2021
Last updated
06/08/2021
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