Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath |
NPI | 1245383835 |
---|---|
Provider Name | Mr. Larry C Milholin |
First Address | Stockton, CA 95209-4703 |
Second Address | Stockton, CA 95209-4703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2007 |
Last Update Date | 08/07/2007 |