Provider Demographics
NPI:1245484492
Name:HINMAN, MITCHELL RAY (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:MITCHELL
Middle Name:RAY
Last Name:HINMAN
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 568
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-0568
Mailing Address - Country:US
Mailing Address - Phone:254-780-4815
Mailing Address - Fax:
Practice Address - Street 1:1686 MORGANS POINT RD
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-6828
Practice Address - Country:US
Practice Address - Phone:254-780-4815
Practice Address - Fax:254-780-4816
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1073047225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist