Healthcare Provider Details

I. General information

NPI: 1861638272
Provider Name (Legal Business Name): DAVID L MILLS MPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2009
Last Update Date: 01/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 PEMBERTON HILL RD SUITE 201
APEX NC
27502-4267
US

IV. Provider business mailing address

981 HIGH HOUSE RD SUITE 100
CARY NC
27513-3510
US

V. Phone/Fax

Practice location:
  • Phone: 919-363-3640
  • Fax: 919-363-3642
Mailing address:
  • Phone: 919-388-0111
  • Fax: 919-388-8668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT009531
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP11339
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: