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General NPI Number Information
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NPI Number | 1366438525
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Entity Type | Individual
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Provider Name | MITCHELL RAYMOND HENRY PT
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Gender | Male
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1165 PHILIPSBURG BIGLER HWY
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City | PHILIPSBURG
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State | PA
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Zip | 16866-8251
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Country | US
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Telephone | 814-342-3930
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Fax | 814-342-3935
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Provider Business Mailing Address
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Address Line | 300 E PLANK RD
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City | ALTOONA
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State | PA
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Zip | 16602-4154
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Country | US
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Telephone | 814-941-7708
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Fax | 814-941-7715
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT007106L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | DAT 000020
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License Number State | PA
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