Individual
CHARLES S MILLS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
12581 MILSTEAD WAY, SUITE 201, WOODBRIDGE, VA 22192
(703) 763-3922
(703) 763-3927
Mailing address
15519 TODDSBURY LN, MANASSAS, VA 20112-5420
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2305006481
LICENSE#
VA
Enumeration date
11/03/2006
Last updated
06/08/2009
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