Provider Demographics
NPI:1467437988
Name:MILLS, JOYCE A (MPT)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:A
Last Name:MILLS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:A
Other - Last Name:MIDDENDORP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2853 S SOSSAMAN RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-9625
Mailing Address - Country:US
Mailing Address - Phone:480-373-9700
Mailing Address - Fax:480-373-9800
Practice Address - Street 1:2853 S SOSSAMAN RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-9625
Practice Address - Country:US
Practice Address - Phone:480-373-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009047225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0186336OtherSTATE DEPT OF LABOR & IND
WAPT00009047OtherSTATE HEALTH DEPT
WA8398018Medicaid
WA0186336OtherSTATE DEPT OF LABOR & IND
P84203Medicare UPIN