Individual
COREY M MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH3966
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-42956
BC BS OF AL
AL
Enumeration date
08/15/2007
Last updated
11/12/2007
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