| Doctor Name: | MAX GARRISON MITCHELL |
| NPI Number: | 1861761967 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN |
| License Number: | N-38315 |
| Business Practice Address: | 107 H Street Poplar, MT - 592550067 |
| Business Phone Number: | 4067682156 |
| Business Fax Number: | 4067685109 |
| Mailing Address: | 107 H Street, POPLAR |
| State: | MT |
| Postal Code: | 592550067 |
| Phone Number: | 4067682156 |
| Fax Number: | 4067685109 |
| NPI Enumeration Date: | 12/19/2011 |
| NPI Last Update Date: | 12/19/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0000X |
| License Number: | N-38315 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | General Practice |
| Taxonomy Definition: | |