| NPI | 1770818759 |
|---|---|
| Doing Business As | THORNELL MITCHELL |
| Entity Type | Organization |
| Authorized Contact | GLORIA D KENNISON Office Manager 337-433-1919 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: LA 1137) |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2009-10-09 |