Provider Demographics
NPI:1699728220
Name:MILLS, ANTOINETTE MARIE (PT)
Entity type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:MARIE
Last Name:MILLS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ANTOINETTE
Other - Middle Name:MARIE
Other - Last Name:MCGRATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:171 DWH
Mailing Address - Street 2:UNIT 11
Mailing Address - City:BELMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03220
Mailing Address - Country:US
Mailing Address - Phone:603-524-3397
Mailing Address - Fax:603-524-9364
Practice Address - Street 1:171 DWH
Practice Address - Street 2:UNIT 11
Practice Address - City:BELMONT
Practice Address - State:NH
Practice Address - Zip Code:03220
Practice Address - Country:US
Practice Address - Phone:603-524-3397
Practice Address - Fax:603-524-9364
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2747225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30391941Medicaid
NH30391941Medicaid