MEDICARE: DR. KEITH D. MILLS D.C.

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
1	111N00000X	Chiropractor	DC0000000339	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770636169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEITH D. MILLS D.C.

Provider Business Mailing Address
First Line	:	2509 OCOEE ST N
Second Line	:	SUITE D
City	:	CLEVELAND
State	:	TN
Zip	:	37312-5369
Country	:	US
Telephone Number	:	423-478-2225
Fax Number	:	423-479-7080

Provider Business Practice Location Address
First Line	:	2509 OCOEE ST N
Second Line	:	SUITE D
City	:	CLEVELAND
State	:	TN
Zip	:	37312-5369
Country	:	US
Telephone Number	:	423-478-2225
Fax Number	:	423-479-7080

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	07/08/2007

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