Healthcare Provider Details

I. General information

NPI: 1710810254
Provider Name (Legal Business Name): ADAM MITCHELL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ADAM MEREDITH

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

193 E WHITTIER ST
COLUMBUS OH
43206-2638
US

IV. Provider business mailing address

856 W RICH ST
COLUMBUS OH
43222-1626
US

V. Phone/Fax

Practice location:
  • Phone: 614-254-8064
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.027175
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: