Provider Demographics
NPI:1790891059
Name:MITCHELL, JAMIE A (PHYSICAL THERAPY AST)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:A
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:PHYSICAL THERAPY AST
Other - Prefix:
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Mailing Address - Street 1:360 ABBEDALE CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-7009
Mailing Address - Country:US
Mailing Address - Phone:317-569-7329
Mailing Address - Fax:317-329-1001
Practice Address - Street 1:7112 ZIONSVILLE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-2163
Practice Address - Country:US
Practice Address - Phone:317-329-1000
Practice Address - Fax:317-329-1001
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN06002339A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant