Provider Demographics
NPI:1093036881
Name:MILTON CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:MILTON CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STACY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-454-1200
Mailing Address - Street 1:1536 KIRKWOOD HWY
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-5716
Mailing Address - Country:US
Mailing Address - Phone:302-454-1200
Mailing Address - Fax:302-454-1238
Practice Address - Street 1:113 UNION ST
Practice Address - Street 2:SUITE A
Practice Address - City:MILTON
Practice Address - State:DE
Practice Address - Zip Code:19968-1600
Practice Address - Country:US
Practice Address - Phone:302-684-1995
Practice Address - Fax:302-684-1559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2010103407111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty