Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT011955 | GA |
NPI | 1023417599 |
---|---|
Provider Name | Andrea Millea |
First Address | Atlanta, GA 30306-3617 |
Second Address | Atlanta, GA 30306-3617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2014 |
Last Update Date | 28/06/2019 |