Provider Demographics
NPI:1992362586
Name:MITCHELL, RYAN JOSHUA (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:JOSHUA
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 1:10555 LAKE FOREST BLVD STE 7C
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-5202
Mailing Address - Country:US
Mailing Address - Phone:504-237-3372
Mailing Address - Fax:
Practice Address - Street 1:10555 LAKE FOREST BLVD STE 7C
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-5202
Practice Address - Country:US
Practice Address - Phone:504-766-7717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1809111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor