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NPI Code Detail

MEDICARE: ANDREW DAVID MILLS D.P.T

MEDICARE: ANDREW DAVID MILLS D.P.T
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT25920FL

General Provider Information

NPI Number : 1578872883
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW DAVID MILLS D.P.T
Provider Business Mailing Address
First Line : 128A ULLIAN TRL
Second Line :
City : PALM COAST
State : FL
Zip : 32164-5923
Country : US
Telephone Number : 386-871-4274
Fax Number :
Provider Business Practice Location Address
First Line : 1764 S WOODLAND BLVD
Second Line :
City : DELAND
State : FL
Zip : 32720-7915
Country : US
Telephone Number : 386-734-9400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2010
Last Update Date : 10/04/2010

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