Healthcare Provider Details

I. General information

NPI: 1447310701
Provider Name (Legal Business Name): MARK ANSON MILLS DIPL. AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 W LINDSEY ST SUITE C-160
NORMAN OK
73069-4159
US

IV. Provider business mailing address

1818 W LINDSEY ST SUITE C-160
NORMAN OK
73069-4159
US

V. Phone/Fax

Practice location:
  • Phone: 405-321-5546
  • Fax:
Mailing address:
  • Phone: 405-321-5546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number625
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: