Individual
GEORGE WELLINGTON MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CTRS
Contact information
Practice address
30901 PALMER RD, WESTLAND, MI 48186-9529
(734) 367-8473
(734) 722-9524
Mailing address
6649 WESTWOOD CT, W BLOOMFIELD, MI 48322-1371
(248) 592-1967
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
24390
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508883299
WRPH
MI
01
—
24390
NATL CNCIL -THER REC CERT
—
Enumeration date
08/14/2007
Last updated
08/14/2007
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