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General NPI Number Information
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NPI Number | 1417521022
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Entity Type | Individual
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Provider Name | GREGORY JOHN MILLS DPT
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Gender | Male
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Dates
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Enumeration Date | 05/18/2021
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 400 NORTH ST STE 2
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City | SACO
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State | ME
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Zip | 04072-1867
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Country | US
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Telephone | 207-282-7121
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Fax |
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Provider Business Mailing Address
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Address Line | 64 OAK RIDGE DR
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City | STANDISH
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State | ME
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Zip | 04084-6048
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Country | US
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Telephone | 207-749-0749
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT5953
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License Number State | ME
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