Provider Demographics
NPI:1033740675
Name:MCMILLIAN, RAMONA (LMT)
Entity Type:Individual
Prefix:
First Name:RAMONA
Middle Name:
Last Name:MCMILLIAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 PRIVATE DRIVE 302
Mailing Address - Street 2:
Mailing Address - City:PROCTORVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45669-8192
Mailing Address - Country:US
Mailing Address - Phone:304-939-1751
Mailing Address - Fax:
Practice Address - Street 1:1020 PIKE ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:WV
Practice Address - Zip Code:25541-1232
Practice Address - Country:US
Practice Address - Phone:304-743-9462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-02
Last Update Date:2020-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20020863225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist