Provider Demographics
NPI:1114162914
Name:MCMILLAN INC.
Entity Type:Organization
Organization Name:MCMILLAN INC.
Other - Org Name:MCMILLAN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMILLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-475-9500
Mailing Address - Street 1:5677 S 1475 E STE 1A
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-7003
Mailing Address - Country:US
Mailing Address - Phone:801-475-9500
Mailing Address - Fax:801-475-9505
Practice Address - Street 1:5677 S 1475 E STE 1A
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-7003
Practice Address - Country:US
Practice Address - Phone:801-475-9500
Practice Address - Fax:801-475-9505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000057459Medicare UPIN