Provider Demographics
NPI:1417418039
Name:MCMILLAN, RAHSAN DEMARCUS (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:RAHSAN
Middle Name:DEMARCUS
Last Name:MCMILLAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 NORTHWAY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-2239
Mailing Address - Country:US
Mailing Address - Phone:980-722-4722
Mailing Address - Fax:
Practice Address - Street 1:3627 BEATTIES FORD RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-3249
Practice Address - Country:US
Practice Address - Phone:704-394-6677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist