Individual
MRS. JOAN ANITA MCMILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
21 ANGELA LN, BILLERICA, MA 01821-2906
(978) 667-8059
Mailing address
21 ANGELA LN, BILLERICA, MA 01821-2906
(978) 667-8059
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1612
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1612
MA PT LICENSE
MA
Enumeration date
05/07/2007
Last updated
07/08/2007
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