Provider Demographics
NPI:1366840183
Name:MILLS, ROBERT M (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
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 1:1 NOVAK DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-3753
Mailing Address - Country:US
Mailing Address - Phone:540-288-0280
Mailing Address - Fax:540-288-3313
Practice Address - Street 1:1 NOVAK DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-3753
Practice Address - Country:US
Practice Address - Phone:540-288-0280
Practice Address - Fax:540-288-3313
Is Sole Proprietor?:No
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557213111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0104557213OtherMEDICAL LICENSE STATE OF VIRGINIA