Individual
DR. MILLICENT K CHANNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
42 E LAUREL RD STE 1700, STRATFORD, NJ 08084-1354
(856) 566-7010
(856) 566-6956
Mailing address
42 E LAUREL RD STE 1700, STRATFORD, NJ 08084-1354
(856) 566-7010
(856) 566-6956
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
MB07492500
NJ
207Q00000X
Family Medicine Physician
MB07492500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0068381
—
NJ
Enumeration date
01/23/2006
Last updated
03/07/2024
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