Mr Enoch Richard Mills, MPT | |
3605 Wesley St, Culver City, CA 90232-2434 | |
(801) 602-6780 | |
Not Available |
Full Name | Mr Enoch Richard Mills |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 3605 Wesley St, Culver City, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629325147 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 39227 (California) | Primary |
Provider Name | Ihc Health Services Inc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1033822085 PECOS PAC ID: 1850209420 Enrollment ID: O20230627000064 |
Mailing Address | Practice Location Address |
---|---|
Mr Enoch Richard Mills, MPT 3605 Wesley St, Culver City, CA 90232-2434 Ph: (801) 602-6780 | Mr Enoch Richard Mills, MPT 3605 Wesley St, Culver City, CA 90232-2434 Ph: (801) 602-6780 |
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