Individual
MIRACLE MCMILLIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8540 SCARBOROUGH DR, COLORADO SPRINGS, CO 80920-7502
(719) 630-7500
Mailing address
4505 W JUNIPER DR APT F, USAF ACADEMY, CO 80840-1229
(303) 956-7740
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
13105
CO
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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