Provider Demographics
NPI:1225446628
Name:MILANI, ROBERT JON JR
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JON
Last Name:MILANI
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 RAMIREZ ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-4334
Mailing Address - Country:US
Mailing Address - Phone:530-923-8526
Mailing Address - Fax:
Practice Address - Street 1:1617 RAMIREZ ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-4334
Practice Address - Country:US
Practice Address - Phone:530-923-8526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT2139225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant