Individual ProviderMitchell MckinleyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address3097 Moorpark Ave Ste 100, San Jose, CA 95128-2543(669) 247-6170PECOS EnrollmentBased on the most recent information from CMS, provider Mitchell Mckinley does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1740007806Provider TypeIndividualFull NameMckinley, MitchellGenderMaleSole ProprietorNoEnumeration Date9/20/2024Last Updated1/8/2025Contact InformationPractice LocationPractice Address3097 Moorpark Ave Ste 100, San Jose, CA 95128-2543Phone(669) 247-6170FaxUnlisted FaxMailing LocationMailing Address1410 Oak St Ste 100, Eugene, OR 97401-4668PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted IssuerCalifornia