Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1346499647 |
---|---|
Provider Name | Josh Millet |
First Address | Slidell, LA 70461-5418 |
Second Address | Slidell, LA 70461-5418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2008 |
Last Update Date | 24/09/2008 |