Jeremy Mitchell

Individual provider Orthopedic Physical Therapist · NPI 1003215682

Jeremy Mitchell is a Physical Therapist in Private Practice in Lompoc, California. Qualified in 2016, 10 years ago. Practices as a sole proprietor. Licensed in Arizona.

Years since qualifying: 10
Licensed in: AZ
In the registry since: 2014

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Practice location Address checks out

805 E Walnut Ave
Lompoc, CA 93436-7027
Phone: (805) 735-3714

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopedic Physical Therapist (primary)	Taxonomy 2251X0800X · Licence 10986PT (AZ)

Record details

NPI number	1003215682
Entity type	Individual (Type 1)
Gender	Male
Sole proprietor	Yes
NPI enumerated	August 19, 2014
Last updated in NPPES	November 19, 2014
Mailing address	259 Riverdale Ct Apt 236, Camarillo, CA 93012-7775

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialty	PHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical school	OTHER
Graduated	2016 (10 years in practice)
Accepts Medicare assignment	Not indicated