Most Relevant Information
Provider Data
| NPI Number: | 1003215682 |
| Provider Name: | JEREMY MITCHELL |
| Entity Type: | Individual |
| Taxonomy Code: | 2251X0800X |
| Specialty: | Physical Therapist |
| License Number: | 10986PT |
Most Important Dates
| Enumeration Date: | 08/19/2014 |
| Last Updated: | 11/19/2014 |
Provider Practice Location
805 E WALNUT AVE
LOMPOC
CA
934367027
Practice Location Phone/Fax
| Phone: | 8057353714 |
| Fax: |
Provider Mailing Location
259 RIVERDALE CT APT 236
CAMARILLO
CA
930127775
Provider Mailing Phone/Fax
| Phone: | 8054787263 |
| Fax: |