Provider Demographics
NPI:1104225564
Name:MILLS, JEFFREY (PT)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:MILLS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6825 E TENNESSEE AVE
Mailing Address - Street 2:SUITE 550
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-1628
Mailing Address - Country:US
Mailing Address - Phone:303-872-1980
Mailing Address - Fax:303-695-5013
Practice Address - Street 1:6825 E TENNESSEE AVE
Practice Address - Street 2:SUITE 550
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1628
Practice Address - Country:US
Practice Address - Phone:303-872-1980
Practice Address - Fax:303-695-5013
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-21
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0013103225100000X
FLPT29629225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist