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General NPI Number Information
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NPI Number | 1750522090
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Entity Type | Individual
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Provider Name | ROBERT S MILAN LADC
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Gender | Male
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Dates
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Enumeration Date | 03/17/2009
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Last Update Date | 03/17/2009
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Provider Practice Location Address
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Address Line | 1002 W GORE BLVD
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City | LAWTON
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State | OK
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Zip | 73501-3723
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Country | US
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Telephone | 580-351-1010
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Fax | 580-351-0084
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Provider Business Mailing Address
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Address Line | PO BOX 214
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City | LAWTON
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State | OK
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Zip | 73502-0214
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Country | US
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Telephone | 580-351-1010
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Fax | 580-351-0084
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 58
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License Number State | OK
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