Individual
DR. THERESE MARIE MILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT DPT
Contact information
Practice address
4600 RIO ST, FARMINGTON, NM 87402-4904
(720) 350-2933
Mailing address
4600 RIO ST, FARMINGTON, NM 87402-4904
(720) 350-2933
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3176
NM
Other
Enumeration date
01/27/2014
Last updated
01/27/2014
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