Provider Demographics
NPI:1710196944
Name:MILLS, DANIEL G (MPT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:G
Last Name:MILLS
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 711088
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84171-1088
Mailing Address - Country:US
Mailing Address - Phone:801-924-4214
Mailing Address - Fax:801-924-4213
Practice Address - Street 1:7827 S HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84121-5032
Practice Address - Country:US
Practice Address - Phone:801-938-9234
Practice Address - Fax:801-849-8416
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT370112-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist