Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | B473 | NV |
NPI | 1235145640 |
---|---|
Provider Name | Dr. Darren L Mitchell |
First Address | Carson City, NV 89706-3036 |
Second Address | Carson City, NV 89706-3036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B473 | STATE LICENSE NUMBER (01) | NV |