Individual
TINA MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 S MOORE AVE, CLAREMORE, OK 74017-5047
(918) 342-6530
Mailing address
PO BOX 1, CHELSEA, OK 74016-0001
(918) 342-6530
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L36089
OK
Other
Enumeration date
09/18/2015
Last updated
09/18/2015
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