Individual
COLIN TOLENTINO MILLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1515 PARK AVE, COLUMBUS, WI 53925-2402
(920) 623-2200
Mailing address
1515 PARK AVE, COLUMBUS, WI 53925-2402
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
75923-20
WI
Other
Enumeration date
04/09/2019
Last updated
09/08/2022
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