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NPI Code Detail

MEDICARE: DR. BRIAN MICHAEL MITCHELL DC

MEDICARE: DR. BRIAN MICHAEL MITCHELL DC
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
1111N00000XChiropractorDC011536PA

General Provider Information

NPI Number : 1306473707
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN MICHAEL MITCHELL DC
Provider Business Mailing Address
First Line : 2808 SOUTHAMPTON RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19154-1207
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2808 SOUTHAMPTON RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19154-1207
Country : US
Telephone Number : 215-637-1212
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2020
Last Update Date : 03/25/2020

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