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Individual

MR. JAY R MILLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
2325 CORONADO ST, IDAHO FALLS, ID 83404-7407
(208) 557-2800
Mailing address
PO BOX 2018, EVANSTON, WY 82931-2018
(801) 540-5545

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1423
WY
225100000X
Physical Therapist
8222367-2401
UT
225100000X
Physical Therapist
Primary
PT-4285
ID

Other

Enumeration date
03/06/2013
Last updated
10/08/2015
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