Individual
DOUGLAS MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T.
Contact information
Practice address
25229 S SUN LAKES BLVD, STE 119, SUN LAKES, AZ 85248-6453
(480) 883-6734
(480) 895-8143
Mailing address
25229 S SUN LAKES BLVD, STE 119, SUN LAKES, AZ 85248-6453
(480) 883-6734
(480) 895-8143
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0PT276730
CA
225100000X
Physical Therapist
5493
OR
225100000X
Physical Therapist
Primary
9812
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139649
MEDICARE PTAN
OR
Enumeration date
03/13/2007
Last updated
07/02/2012
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