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Individual

LAUREN MCMILLON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC, LAT, CES, ITAT

Contact information

Practice address
580 GOVERNOR RITCHIE HWY, SUITE E, SEVERNA PARK, MD 21146-3924
(443) 261-2243
(410) 384-1613
Mailing address
580 GOVERNOR RITCHIE HWY, SUITE E, SEVERNA PARK, MD 21146-3924
(443) 261-2243
(410) 384-1613

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A00047
MD
2255A2300X
Athletic Trainer
J3-0000415
DE

Other

Enumeration date
12/28/2016
Last updated
12/28/2016
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