Individual
FREDDIE LAREDIA MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26 BRENTSHIRE SQ STE R, JACKSON, TN 38305-2265
(731) 343-5313
Mailing address
24 MAY DR, JACKSON, TN 38305-4643
(731) 343-5313
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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