Dallas Benjamin Mitchell, DC | |
1600 Gratiot Blvd Ste 6, Marysville, MI 48040-1145 | |
(810) 637-1205 | |
Not Available |
Full Name | Dallas Benjamin Mitchell |
---|---|
Gender | Male |
Speciality | Chiropractor |
Location | 1600 Gratiot Blvd Ste 6, Marysville, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114653383 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 2531401182 (Michigan) | Secondary |
111N00000X | Chiropractor | 2301401317 (Michigan) | Primary |
Provider Name | Mitchell Chiropractic Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1568170934 PECOS PAC ID: 5395199905 Enrollment ID: O20231002001081 |
Mailing Address | Practice Location Address |
---|---|
Dallas Benjamin Mitchell, DC 1214 Short St, Port Huron, MI 48060-4343 Ph: (810) 824-0693 | Dallas Benjamin Mitchell, DC 1600 Gratiot Blvd Ste 6, Marysville, MI 48040-1145 Ph: (810) 637-1205 |
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