Individual
STACY MILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6931 RIVER PARK CIR, FORT WORTH, TX 76116-8465
(817) 731-7611
Mailing address
4409 LONGMEADOW WAY, FORT WORTH, TX 76133-7407
(817) 875-2777
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2067546
TX
Other
Enumeration date
09/09/2025
Last updated
09/09/2025
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