Healthcare Provider Details

I. General information

NPI: 1649635723
Provider Name (Legal Business Name): DARREN MILLS N.D., L.M.T., C.P.T
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2015
Last Update Date: 05/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 S. HUBBARDS LN. STE. 98
LOUISVILLE KY
40207
US

IV. Provider business mailing address

117 S HUBBARDS LN STE 98
LOUISVILLE KY
40207-3900
US

V. Phone/Fax

Practice location:
  • Phone: 502-410-1270
  • Fax:
Mailing address:
  • Phone: 502-410-1270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License NumberBMTMTH00216698
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: