Individual
CALEB C MCMILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
305 BONITA ST, JACKSONVILLE, TX 75766-5743
(903) 586-3616
Mailing address
103 RAMBLING RD, CARTHAGE, TX 75633-3283
(903) 754-3370
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209862
TX
Other
Enumeration date
12/04/2007
Last updated
12/04/2007
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