Individual
MR. BRENT LEE MCMILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1501 HILAND AVE, PHYSICAL THERAPY, BURLEY, ID 83318-2682
(208) 677-6530
Mailing address
1180 SYLVAN CIR, BURLEY, ID 83318-3163
(208) 678-4154
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-410
ID
Other
Enumeration date
01/27/2007
Last updated
07/08/2007
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