Individual
MICHAEL L MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3420 BROAD ST, LORIS, SC 29569
(843) 756-6919
(843) 756-6900
Mailing address
PO BOX 797, LORIS, SC 29569
(843) 756-6919
(843) 756-6900
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0639
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8909635
—
NC
05
—
D60394
—
SC
Enumeration date
05/10/2006
Last updated
10/30/2007
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