Individual
MADISON MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2103 N VETERANS PKWY, BLOOMINGTON, IL 61704-0908
(309) 948-6469
Mailing address
2103 N VETERANS PKWY, BLOOMINGTON, IL 61704-0908
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
160.010352
IL
Other
Enumeration date
02/10/2025
Last updated
02/10/2025
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