Healthcare Provider Details

I. General information

NPI: 1659366227
Provider Name (Legal Business Name): JAMES STEPHEN MILONE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 E MAIN ST
CLINTON CT
06413-2036
US

IV. Provider business mailing address

69 E MAIN ST
CLINTON CT
06413-2036
US

V. Phone/Fax

Practice location:
  • Phone: 860-664-3966
  • Fax: 860-669-1801
Mailing address:
  • Phone: 860-664-3966
  • Fax: 860-669-1801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number001207
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: