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NPI 1598237455

NPI 1598237455 : ANTHONY ROBERT MILONE PTA : ELKHORN, NE

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General NPI Number Information
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    NPI Number           |    1598237455
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    Entity Type          |    Individual 
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    Provider Name        |    ANTHONY ROBERT MILONE PTA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/17/2018
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    Last Update Date     |    12/17/2018
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Provider Practice Location Address
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    Address Line         |    19111 MASON PLZ 
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    City                 |    ELKHORN
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    State                |    NE
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    Zip                  |    68022-5659
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    Country              |    US
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    Telephone            |    714-906-9535
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    19111 MASON PLZ 
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    City                 |    ELKHORN
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    State                |    NE
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    Zip                  |    68022-5659
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    Country              |    US
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    Telephone            |    714-906-9535
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    1743
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    License Number State |    NE
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