Provider Demographics
NPI:1538512405
Name:MITCHELL, LAUREN CLAIRE-STELLY (DPT,ATC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:CLAIRE-STELLY
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:DPT,ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2331 20TH ST
Mailing Address - Street 2:
Mailing Address - City:SLAYTON
Mailing Address - State:MN
Mailing Address - Zip Code:56172-1004
Mailing Address - Country:US
Mailing Address - Phone:507-929-7696
Mailing Address - Fax:507-393-7697
Practice Address - Street 1:1401 NWAKAMA ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-5529
Practice Address - Country:US
Practice Address - Phone:507-929-7696
Practice Address - Fax:507-393-7697
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist