Provider Demographics
NPI:1174810592
Name:MILLIGAN, MARK LOUIS (DPT)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:LOUIS
Last Name:MILLIGAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:237 MOONLIT STREAM PASS
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-2697
Mailing Address - Country:US
Mailing Address - Phone:303-523-2441
Mailing Address - Fax:
Practice Address - Street 1:2908 POSTON AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1309
Practice Address - Country:US
Practice Address - Phone:866-719-9611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1208988225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB133875Medicare PIN