| Doctor Name: | MR. DARREL MITTELSTAEDT |
| NPI Number: | 1184043887 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T. |
| License Number: | PT-6288 |
| Business Practice Address: | 6801 Mayfield Rd Hillcrest Medical Building #2 Suite 150 Mayfield Hts, OH - 441242270 |
| Business Phone Number: | 4403128529 |
| Business Fax Number: | 4403126928 |
| Mailing Address: | 6801 Mayfield Rd, Hillcrest Medical Building #2 Suite 150 MAYFIELD HTS |
| State: | OH |
| Postal Code: | 441242270 |
| Phone Number: | 4403128529 |
| Fax Number: | 4403126928 |
| NPI Enumeration Date: | 04/09/2014 |
| NPI Last Update Date: | 04/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | PT-6288 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |