Individual
MARVA DENICE MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
617 BENTON ST, OMAK, WA 98841-9636
(509) 422-5682
(509) 422-7471
Mailing address
617 BENTON ST, OMAK, WA 98841-9636
(509) 422-5682
(509) 422-7471
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
10/26/2018
Last updated
10/26/2018
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