Provider Demographics
NPI:1053514406
Name:MILLS, BRANDON SCOTT (DC)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:SCOTT
Last Name:MILLS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10801 S WESTERN AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-6224
Mailing Address - Country:US
Mailing Address - Phone:405-703-3033
Mailing Address - Fax:
Practice Address - Street 1:10801 S WESTERN AVE STE 400
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-6224
Practice Address - Country:US
Practice Address - Phone:405-703-3033
Practice Address - Fax:405-735-9495
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3843111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor