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Individual

MAX GARRISON MITCHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
107 H STREET, POPLAR, MT 59255-0067
(406) 768-2156
(406) 768-5109
Mailing address
107 H STREET, POPLAR, MT 59255-0067
(406) 768-2156
(406) 768-5109

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
N-38315
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2220068
MT
Enumeration date
12/19/2011
Last updated
12/19/2011
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