Healthcare Provider Details

I. General information

NPI: 1992780506
Provider Name (Legal Business Name): KATHY A MILANO OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 01/11/2022
Certification Date: 01/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13772 DENVER WEST PKWY BLDG#55, STE#100
LAKEWOOD CO
80401-3139
US

IV. Provider business mailing address

13772 DENVER WEST PKWY BLDG#55, STE#100
LAKEWOOD CO
80401-3139
US

V. Phone/Fax

Practice location:
  • Phone: 303-279-6600
  • Fax: 303-279-9140
Mailing address:
  • Phone: 303-279-6600
  • Fax: 303-279-9140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1753
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: