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General NPI Number Information
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NPI Number | 1811610348
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Entity Type | Individual
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Provider Name | DR. BRIAN J. MILLETTE
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Gender | Male
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 5388 DISCOVERY PARK BLVD STE 100
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-8218
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Country | US
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Telephone | 757-903-4230
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Fax | 757-903-4231
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Provider Business Mailing Address
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Address Line | 4701 MONTEREY OAKS BLVD APT 425
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City | AUSTIN
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State | TX
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Zip | 78749-1087
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Country | US
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Telephone | 708-296-7687
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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 | CP034875T
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1367965
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License Number State | TX
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