Healthcare Provider Details

I. General information

NPI: 1154549897
Provider Name (Legal Business Name): MILO DUANE ALLEN D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 E LAKE AVE
WATSONVILLE CA
95076-4424
US

IV. Provider business mailing address

411 E LAKE AVE
WATSONVILLE CA
95076-4424
US

V. Phone/Fax

Practice location:
  • Phone: 831-724-7778
  • Fax: 831-724-1129
Mailing address:
  • Phone: 831-724-7778
  • Fax: 831-724-1129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDC10572
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: