Individual
MICHAEL MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1268 E 32ND ST, SILVER CITY, NM 88061-7229
(575) 534-1919
(575) 534-0135
Mailing address
1268 E 32ND ST, SILVER CITY, NM 88061-7229
(575) 534-1919
(575) 534-0135
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
358
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
358
STATE LICENSE
NM
Enumeration date
07/28/2005
Last updated
03/02/2009
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