NPI 1184449613

Kameron Mitchell, CPO

Practitioner Prosthetist Fort Wayne, IN

Practice location

Address: 5505 Coventry Ln, Fort Wayne, IN 46804-7144
Phone: (317) 522-6380
Mailing address: 3236 Copper Hill Run, Fort Wayne, IN 46804-3425

Registered specialties (2)

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X

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Orthotist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X

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Registry record

NPI: 1184449613
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Nov 2024
Record last updated: 19 Nov 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.