Provider Demographics
NPI:1194368068
Name:MILLS, STEPHEN THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:THOMAS
Last Name:MILLS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 W VANDAMENT AVE
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-3877
Mailing Address - Country:US
Mailing Address - Phone:405-354-5753
Mailing Address - Fax:405-354-5828
Practice Address - Street 1:15510 OLIVE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-0710
Practice Address - Country:US
Practice Address - Phone:636-346-1395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019034782111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor