Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 002543 | KY |
Y | 2251E1300X | Electrophysiology, Clinical | 002543 | KY |
N | 2251X0800X | Physical Therapist - Orthopedic | 002543 | KY |
NPI | 1023007002 |
---|---|
Provider Name | Mr. James Thompson Mills III |
First Address | Tripler Army Medical Center, HI 96859-5001 |
Second Address | Tripler Amc, HI 96859-5001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 23/09/2021 |