Brandon Mitchell, PTA
Physical Therapy Assistant in Lynwood, CA. Individual provider (NPI-1).
NPI number1871373803
StatusActive
Last updated in NPPESOct 8, 2023
Details
- NPI
- 1871373803
- Entity type
- Individual (NPI-1)
- Name
- Brandon Mitchell
- Credential
- PTA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 5, 2023
- Certification date
- Oct 8, 2023
- Last updated
- Oct 8, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | 52689 | CA | Yes |
| 183700000X | Pharmacy Technician | 97930 | CA |
Practice location
3737 Martin Luther King Jr Blvd Ste 604Lynwood, CA 90262-3518
Phone 562-333-3700
Mailing address
11158 Linden StLynwood, CA 90262-2919
Phone 424-205-0329
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