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General NPI Number Information
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NPI Number | 1285509323
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Entity Type | Organization
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Legal Business Name | W MILYANI PC
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Dates
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Enumeration Date | 10/08/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 1301 BERTHA HOWE AVE STE 2
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City | MESQUITE
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State | NV
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Zip | 89027-7503
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Country | US
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Telephone | 435-599-7877
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Fax | 435-359-5021
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Provider Business Mailing Address
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Address Line | 4825 HWY 95 STE 2
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City | FORT MOHAVE
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State | AZ
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Zip | 86426-8315
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Country | US
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Telephone | 435-599-7877
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Fax | 435-359-5021
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Authorized Official
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Title or Position | OWNER
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Name | CLINTON MARTIN
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Credential |
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Telephone | 435-599-7877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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