Most Relevant Information
Provider Data
| NPI Number: | 1003378027 |
| Provider Name: | SUSAN JANE MITCHELL |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 030302 |
Most Important Dates
| Enumeration Date: | 04/01/2019 |
| Last Updated: | 06/19/2024 |
Provider Practice Location
122 W COURT ST STE 106
ITHACA
NY
148504165
Practice Location Phone/Fax
| Phone: | 6072882205 |
| Fax: |
Provider Mailing Location
1212 TRUMANSBURG RD
ITHACA
NY
148501314
Provider Mailing Phone/Fax
| Phone: | 6072882205 |
| Fax: |