Individual
DR. GORDON DALE MILLS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1055 N 500 W # 212, PROVO, UT 84604-3305
(801) 812-5033
Mailing address
1055 N 500 W # 212, PROVO, UT 84604-3305
(801) 812-5033
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
294548-4405
UT
Other
Enumeration date
06/21/2017
Last updated
11/29/2021
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