Individual
KAMREN MILLSAP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2320 LAKE SHORE DR, WACO, TX 76708-1276
(254) 752-1075
Mailing address
6501 SYDNEY DR, WACO, TX 76708-5311
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2113893
—
Other
Enumeration date
09/05/2018
Last updated
09/05/2018
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