Provider Demographics
NPI:1174737480
Name:MITCHELL, ANDREW (DC)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3441 W SAHARA AVE
Mailing Address - Street 2:#C7
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-6061
Mailing Address - Country:US
Mailing Address - Phone:702-220-9191
Mailing Address - Fax:702-220-9292
Practice Address - Street 1:3441 W SAHARA AVE
Practice Address - Street 2:#C7
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-6061
Practice Address - Country:US
Practice Address - Phone:702-220-9191
Practice Address - Fax:702-220-9292
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB702111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV88-0457811OtherTAX ID
NV32485Medicare ID - Type Unspecified
NV88-0457811OtherTAX ID