MEDICARE: MS. DANNA L. MITCHELL L.M.T.

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
1	171W00000X	Contractor

General Provider Information

NPI Number	:	1841510724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DANNA L. MITCHELL L.M.T.

Provider Business Mailing Address
First Line	:	100 S CEDAR ST FL 1
Second Line	:
City	:	OBERLIN
State	:	OH
Zip	:	44074-1522
Country	:	US
Telephone Number	:	440-213-4522
Fax Number	:

Provider Business Practice Location Address
First Line	:	23121 EMERY RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-5136
Country	:	US
Telephone Number	:	216-514-9590
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2010
Last Update Date	:	06/02/2010

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