Individual
WAYNE M MILLS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
40 W FRANKLIN RD, C/O COMMUNICARE, MERIDIAN, ID 83642-2965
(208) 861-3648
Mailing address
9518 SCORPIO ST, BOISE, ID 83709-4745
(208) 322-7660
(208) 362-4978
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
RPT-048
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T-0387
BLUE CROSS OF IDAHO
ID
Enumeration date
11/04/2005
Last updated
07/09/2007
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