Provider Demographics
NPI:1184619686
Name:MCMILLAN, COLE (DC)
Entity type:Individual
Prefix:DR
First Name:COLE
Middle Name:
Last Name:MCMILLAN
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 1:5677 S 1475 E STE 1A
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-7003
Mailing Address - Country:US
Mailing Address - Phone:801-475-9500
Mailing Address - Fax:801-475-9505
Practice Address - Street 1:5677 S 1475 E STE 1A
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-7003
Practice Address - Country:US
Practice Address - Phone:801-475-9500
Practice Address - Fax:801-475-9505
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5132574-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT005745901Medicare ID - Type Unspecified
UT0057459Medicare UPIN