Provider Demographics
NPI:1184857518
Name:MILAM, ROBERT B (PTA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:MILAM
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27240 HAGGERTY RD
Mailing Address - Street 2:SUITE E15
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-5716
Mailing Address - Country:US
Mailing Address - Phone:248-488-0350
Mailing Address - Fax:248-488-0355
Practice Address - Street 1:27240 HAGGERTY RD
Practice Address - Street 2:SUITE E15
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-5716
Practice Address - Country:US
Practice Address - Phone:248-488-0350
Practice Address - Fax:248-488-0355
Is Sole Proprietor?:No
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 15890225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant