Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 9804949-2401 | UT |
NPI | 1033541727 |
---|---|
Provider Name | James Bradford Milam |
First Address | Cottonwood Heights, UT 84121-2924 |
Second Address | Salt Lake City, UT 84101-2215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2013 |
Last Update Date | 04/12/2018 |