Doctor Name: | BROCK MITCHELL |
NPI Number: | 1790835221 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 117923 |
Business Practice Address: | 710 S Business 61 Bowling Green, MO - 633345239 |
Business Phone Number: | 5733246079 |
Business Fax Number: | |
Mailing Address: | 53435 Eagle Ridge Ct, NEW LONDON |
State: | MO |
Postal Code: | 634592431 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/10/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 117923 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |