Individual
MR. ALFONZO MCMILLIAN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11737 BLUE MOON AVE, OKLAHOMA CITY, OK 73162-2004
(405) 535-4786
Mailing address
11737 BLUE MOON AVE, OKLAHOMA CITY, OK 73162-2004
(405) 535-4786
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/13/2010
Last updated
12/13/2010
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