| Doctor Name: | DR. MATTHEW MCMILLIN |
| NPI Number: | 1598197378 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 12225 |
| Business Practice Address: | 4112 Outlook Blvd Suite 96 Pueblo, CO - 810081667 |
| Business Phone Number: | 7195626212 |
| Business Fax Number: | |
| Mailing Address: | 251 W Venturi Dr, PUEBLO WEST |
| State: | CO |
| Postal Code: | 810073609 |
| Phone Number: | 9546291098 |
| Fax Number: | |
| NPI Enumeration Date: | 08/05/2013 |
| NPI Last Update Date: | 08/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 12225 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |