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NPI Code Detail

MEDICARE: NANCY MITCHELL

MEDICARE: NANCY MITCHELL
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
1225200000XPhysical Therapy Assistant10199CA

General Provider Information

NPI Number : 1386043818
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY MITCHELL
Provider Business Mailing Address
First Line : 980 TUFTS CIR
Second Line :
City : CORONA
State : CA
Zip : 92880-7300
Country : US
Telephone Number : 724-454-2003
Fax Number :
Provider Business Practice Location Address
First Line : 3200 INLAND EMPIRE BLVD STE 100
Second Line :
City : ONTARIO
State : CA
Zip : 91764-5569
Country : US
Telephone Number : 909-945-5011
Fax Number : 909-989-6158
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2014
Last Update Date : 08/20/2014

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Directions to “ NANCY MITCHELL ” Practice Location

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