MEDICARE: JULIE L MITCHELL PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT006572	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10037588	OTHER	GA	AMERIGROUP
2	344654	OTHER	GA	WELLCARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578569661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE L MITCHELL PT

Provider Business Mailing Address
First Line	:	263 HIGHWAY 53 E
Second Line	:
City	:	CALHOUN
State	:	GA
Zip	:	30701-3026
Country	:	US
Telephone Number	:	706-624-3000
Fax Number	:	706-624-3001

Provider Business Practice Location Address
First Line	:	263 HIGHWAY 53 E
Second Line	:
City	:	CALHOUN
State	:	GA
Zip	:	30701-3026
Country	:	US
Telephone Number	:	706-624-3000
Fax Number	:	706-624-3001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	07/08/2007

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Directions to “ JULIE L MITCHELL PT” Practice Location

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