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General NPI Number Information
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NPI Number | 1730450941
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Entity Type | Organization
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Legal Business Name | DR. MICHAEL MILICI & ASSOCIATES L.L.C.
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Dates
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Enumeration Date | 01/19/2012
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 3812 LIBERTY HWY SUITE #1
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City | ANDERSON
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State | SC
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Zip | 29621-1344
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Country | US
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Telephone | 864-225-0474
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Fax | 864-225-0547
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Provider Business Mailing Address
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Address Line | 3812 LIBERTY HWY SUITE #1
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City | ANDERSON
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State | SC
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Zip | 29621-1344
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Country | US
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Telephone | 864-225-0474
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Fax | 864-225-0547
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. MICHAEL WILLIAM MILICI
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Credential | O.D.
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Telephone | 864-225-0474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 935
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License Number State | SC
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