Individual
DR. MICAH SEAN MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1702 S KIMBALL AVE, CALDWELL, ID 83605-4826
(208) 459-2641
(208) 459-2895
Mailing address
1702 S KIMBALL AVE, CALDWELL, ID 83605-4826
(208) 459-2641
(208) 459-2895
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3254AT
OR
152W00000X
Optometrist
Primary
ODP100163
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548468580
—
ID
Enumeration date
07/10/2007
Last updated
10/07/2010
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