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General NPI Number Information
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NPI Number | 1831779289
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Entity Type | Organization
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Legal Business Name | MILFORD FAMILY PRACTICE
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Dates
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Enumeration Date | 04/10/2021
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Last Update Date | 04/10/2021
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Provider Practice Location Address
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Address Line | 103 SMITH ST
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City | MILFORD
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State | KS
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Zip | 66514-5049
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Country | US
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Telephone | 785-463-3333
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 186
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City | MILFORD
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State | KS
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Zip | 66514-0186
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Country | US
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Telephone | 785-463-3333
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Fax | 785-463-3343
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Authorized Official
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Title or Position | OWNER
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Name | SHANA CHRISTINE ROETHER
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Credential | NP
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Telephone | 785-463-3333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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