Healthcare Provider Details

I. General information

NPI: 1043542699
Provider Name (Legal Business Name): NEIL E MILLS RT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2010
Last Update Date: 02/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 EXEMPLA CIR
LAFAYETTE CO
80026-3370
US

IV. Provider business mailing address

280 EXEMPLA CIR
LAFAYETTE CO
80026-3370
US

V. Phone/Fax

Practice location:
  • Phone: 720-536-7412
  • Fax:
Mailing address:
  • Phone: 720-536-7412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number2089
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: