Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 002866 | KY |
NPI | 1225235716 |
---|---|
Provider Name | Mrs. Angela M Mills |
First Address | Owensboro, KY 42303-1610 |
Second Address | Owensboro, KY 42301-0328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 08/07/2007 |