Corey Mills, PTA
Individual provider Active NPI Contractor · Sherwood, AR
NPI 1023314432 · NPPES record last updated Feb 2, 2011
Key facts
- NPI
- 1023314432
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- PTA 1244 (AR)
- Practice address
- 9880 Brockington Rd
Suite 147
Sherwood, AR 72120-3585 - Phone
- (501) 944-7819
- NPI assigned
- Feb 2, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA 1244 | AR | MD | Contractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Therapy Institute | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | PTA 1244 | AR | Yes |
Addresses
Primary practice location
9880 Brockington Rd
Suite 147
Sherwood, AR 72120-3585
Mailing address
22 Vista Dr
Little Rock, AR 72210-1720
Phone (501) 412-3509
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1 | Other | AR | NA |
Other providers in Sherwood, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.