Organization
MITZI CREEL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITZI T CREEL (DISABILITY)
(434) 394-4244
Entity
Organization
Contact information
Practice address
105 WINGCUP WAY, SIMPSONVILLE, SC 29680-6872
(434) 394-4244
Mailing address
105 WINGCUP WAY, SIMPSONVILLE, SC 29680-6872
(434) 394-4244
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
C640558626680
FL
Other
Enumeration date
12/16/2016
Last updated
12/16/2016
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