Healthcare Provider Details

I. General information

NPI: 1760522254
Provider Name (Legal Business Name): STEPHANIE ANN MILLS D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

556 PEMBROKE ST
PEMBROKE NH
03275-3246
US

IV. Provider business mailing address

556 PEMBROKE ST
PEMBROKE NH
03275-3246
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-4281
  • Fax: 603-224-4281
Mailing address:
  • Phone: 603-224-4281
  • Fax: 603-224-4281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6171200
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: