Individual
CALEB MITZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9109 LIBERTY RD, RANDALLSTOWN, MD 21133
(410) 655-7373
Mailing address
6706 WHITEGATE RD, CLARKSVILLE, MD 21029-1620
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A4932
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5485218
—
MD
Enumeration date
03/16/2018
Last updated
07/11/2018
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