Provider Demographics
NPI:1912102153
Name:MILLS, ROBIN MARIE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:MARIE
Last Name:MILLS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MISS
Other - First Name:ROBIN
Other - Middle Name:MARIE
Other - Last Name:LOSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:W218 N14145 HILLTOP CT
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53076-9659
Mailing Address - Country:US
Mailing Address - Phone:414-507-6207
Mailing Address - Fax:
Practice Address - Street 1:19525 W NORTH AVE
Practice Address - Street 2:WHEATON FRANCISCAN HEALTHCARE MARIAN FRANCISCAN SERVICE
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045
Practice Address - Country:US
Practice Address - Phone:262-785-1114
Practice Address - Fax:262-780-3805
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5800024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40309700Medicaid