Individual
MS. DAVISA RENEE MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3008
Mailing address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3008
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
020909
NY
363A00000X
Physician Assistant
MA063381
PA
Other
Enumeration date
06/20/2017
Last updated
12/19/2023
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