Most Relevant Information
Provider Data
| NPI Number: | 1003316787 |
| Provider Name: | DIMAGGIO TERRELL MITCHELL |
| Entity Type: | Individual |
| Taxonomy Code: | 3747A0650X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/19/2018 |
| Last Updated: | 02/19/2018 |
Provider Practice Location
6221 ANACONDA ST
LAS VEGAS
NV
891083934
Practice Location Phone/Fax
| Phone: | 7022403800 |
| Fax: |
Provider Mailing Location
6221 ANACONDA ST
LAS VEGAS
NV
891083934
Provider Mailing Phone/Fax
| Phone: | 7022403800 |
| Fax: |