Provider Demographics
NPI:1871379743
Name:MITCHELL, PAUL (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6115 ABBOTTS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-5751
Mailing Address - Country:US
Mailing Address - Phone:478-278-3030
Mailing Address - Fax:
Practice Address - Street 1:6115 ABBOTTS BRIDGE RD APT 208
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-5753
Practice Address - Country:US
Practice Address - Phone:478-278-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA016104225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist