R Mitchell Hiserote D.O.

NPI 1053525113 - Neuromusculoskeletal Medicine & OMM - 204D00000X

NPI Details
NPI 1053525113
Gender Male
Enumeration Date 05/09/2007
Last Updated 10/05/2012
Entity Type Individual
Active Over 9 years ago
Practice Location
496 S MAIN ST
SEBASTOPOL CA, 95472-4211, US
Phone (707) 824-8764
Fax (707) 824-8766
Business Location
648 MCGINNIS CIR
COTATI CA, 94931-7718, US
Phone (559) 999-8647
Fax (707) 824-8766
Toxanomy
Taxonomy Code 204D00000X
License State California
License Number 20A7465
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According to our database, Dr. R Mitchell Hiserote D.O. NPI is 1053525113, taxonomy code is 204D00000X and license number is 20A7465, license state is located at California. R Mitchell Hiserote D.O. physically located at 496 S Main St, Sebastopol CA, 95472-4211. NPI Number R Mitchell Hiserote D.O. has the Individual type.

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1053525113 NPI number is provided on an as is basis without warranty of any kind. 1053525113 is maintained by the National Plan & Provider Enumeration System. The contents of R Mitchell Hiserote D.O. are for informational purposes only.