MICHAEL SHANE MITCHELL

CAMP LEJEUNE, NC
NPI1194168807
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2013-04-11
Last Update Date2013-04-11
Business Address
-- MICHAEL SHANE MITCHELL IDC
5371 WASHINGTON ST
CAMP LEJEUNE, NC 28547-1104
Phone number: 843-640-2075
Mailing Address
-- MICHAEL SHANE MITCHELL IDC
5371 WASHINGTON ST
CAMP LEJEUNE, NC 28547-1104
Phone number: 843-640-2075