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Individual

KEITH MILLS SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
130 BIG SHOT LN, GASTON, SC 29053-8216
(803) 553-3189
Mailing address
130 BIG SHOT LN, GASTON, SC 29053-8216
(803) 553-3189

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
376J00000X
Homemaker
Primary

Other

Enumeration date
06/17/2013
Last updated
06/17/2013
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