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Individual

MR. MARK TIMOTHY MITCHUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2022 BATTERY PARK DR, GLENDALE, KY 42740
(859) 314-3670
Mailing address
311 HILLVIEW DR, HORSE CAVE, KY 42749-8048
(270) 540-1080

Taxonomy

Speciality
Code
Description
License number
State
163WX0106X
Occupational Health Registered Nurse
Primary
1112028
KY

Other

Enumeration date
12/17/2024
Last updated
12/17/2024
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