National Provider Identifier
Susan Jane Mitchell
Susan Jane Mitchell is listed in the NPPES registry with a primary specialty of Massage Therapist in Ithaca, NY and a listed phone number of (607) 288-2205.
Profile Overview
- NPI
- 1003378027
- Provider Type
- Individual
- Primary Specialty
- Massage Therapist
- Enumeration Date
- April 01, 2019
- Last Updated
- June 19, 2024
Practice Location
- 122 W Court St Ste 106
- Ithaca, NY 14850-4165
Phone: (607) 288-2205
Mailing Address
- 1212 Trumansburg RD
- Ithaca, NY 14850-1314
Specialties
- Massage Therapist (225700000X)
Full Record
- NPI
- 1003378027
- Entity Type
- Individual
- Last Name
- Mitchell
- First Name
- Susan
- Middle Name
- Jane
- Name Prefix
- Mrs.
- Mailing Street Address
- 1212 Trumansburg RD
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-1314
- Mailing Country
- US
- Mailing Phone
- (607) 288-2205
- Practice Street Address
- 122 W Court St Ste 106
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-4165
- Practice Country
- US
- Practice Phone
- (607) 288-2205
- Enumeration Date
- April 01, 2019
- Last Updated
- June 19, 2024
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- June 19, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Massage Therapist (225700000X)