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General NPI Number Information
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NPI Number | 1881965952
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Entity Type | Individual
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Provider Name | AIMEE M MITCHELL ATC
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Gender | Female
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Dates
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Enumeration Date | 01/22/2012
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 268 S FINLEY AVE
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-1435
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Country | US
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Telephone | 908-204-2585
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Fax | 908-204-1356
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Provider Business Mailing Address
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Address Line | 32 ROCK RD
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City | LONG VALLEY
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State | NJ
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Zip | 07853-3301
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Country | US
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Telephone | 973-906-1426
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 25MT00116700
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License Number State | NM
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