Provider Demographics
NPI:1083693675
Name:MITCHELL, KEVIN COLE (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:COLE
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 COTTONWOOD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-3033
Mailing Address - Country:US
Mailing Address - Phone:325-676-1624
Mailing Address - Fax:325-676-1678
Practice Address - Street 1:1633 COTTONWOOD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-3033
Practice Address - Country:US
Practice Address - Phone:325-676-1624
Practice Address - Fax:325-676-1678
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC5177111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX603098OtherBLUE CROSS BLUE SHIELD
TX603098OtherBLUE CROSS BLUE SHIELD