Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 5502003780 | MI |
NPI | 1013398361 |
---|---|
Provider Name | Mrs. Heather Mills |
First Address | Greenville, MI 48838-2190 |
Second Address | Greenville, MI 48838-2190 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2015 |
Last Update Date | 12/06/2015 |