Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC16635 | CA |
NPI | 1053419473 |
---|---|
Provider Name | Dr. Judi G. Milin |
First Address | Idyllwild, CA 92549-3157 |
Second Address | Idyllwild, CA 92549-3157 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |