Individual
CONNIE J MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6631 E 2ND ST, CASPER, WY 82609-4355
(307) 268-9904
(307) 268-9907
Mailing address
6631 E 2ND ST, CASPER, WY 82609-4355
(307) 268-9904
(307) 268-9907
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-057
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114651300
—
WY
Enumeration date
07/19/2006
Last updated
12/07/2010
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