Provider Demographics
NPI:1790526069
Name:MILLS, JOLIN (PT, DPT)
Entity type:Individual
Prefix:
First Name:JOLIN
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
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 1:2948 HOGAN DR
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-6078
Mailing Address - Country:US
Mailing Address - Phone:307-258-9426
Mailing Address - Fax:307-224-6463
Practice Address - Street 1:2948 HOGAN DR
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-6078
Practice Address - Country:US
Practice Address - Phone:307-258-9426
Practice Address - Fax:307-224-6463
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY2388225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist