Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2080 | SC |
NPI | 1003997677 |
---|---|
Provider Name | Dr. Patrick L. Milligan |
First Address | Greenwood, SC 29649-3125 |
Second Address | Greenwood, SC 29649-3125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 07/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CH2080 | (05) | SC |
U88841 | (02) | SC |