Individual
MR. PHILLIP ANTHONY MILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
5425 MCWILLIAMS ROAD, BLDG 5425, CAMP BULLIS, TX 78257
(210) 295-8337
Mailing address
11500 FENWAY SOUTH DR, FORT MYERS, FL 33913-8671
(816) 510-6837
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AL4509
FL
2255A2300X
Athletic Trainer
Primary
AT7733
TX
Other
Enumeration date
09/01/2016
Last updated
04/02/2021
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