Provider Demographics
NPI:1437570645
Name:MILLS, THERESA V (ARDMS)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:V
Last Name:MILLS
Suffix:
Gender:F
Credentials:ARDMS
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:V
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARDMS
Mailing Address - Street 1:24 ROUTE 134
Mailing Address - Street 2:
Mailing Address - City:SOUTH DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02660-3739
Mailing Address - Country:US
Mailing Address - Phone:508-394-4847
Mailing Address - Fax:508-394-3638
Practice Address - Street 1:1 E MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1662
Practice Address - Country:US
Practice Address - Phone:508-394-4847
Practice Address - Fax:508-394-3638
Is Sole Proprietor?:No
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY21008111NR0200X, 174400000X, 246YC3302X, 2471S1302X, 247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No111NR0200XChiropractic ProvidersChiropractorRadiology
No174400000XOther Service ProvidersSpecialist
No246YC3302XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Physician Office Based
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA21008OtherARDMS