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General NPI Number Information
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NPI Number | 1376328260
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Entity Type | Individual
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Provider Name | KAYLA MILLS
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Gender | Female
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Dates
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Enumeration Date | 08/29/2023
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 425 ERNEST W BARRETT PKWY NW
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City | KENNESAW
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State | GA
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Zip | 30144-4990
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Country | US
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Telephone | 470-257-4544
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Fax |
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Provider Business Mailing Address
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Address Line | 3235 BLUE SPRINGS TRCE NW
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City | KENNESAW
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State | GA
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Zip | 30144-1112
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Country | US
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Telephone | 470-257-4544
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | CO135252
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License Number State | GA
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