Provider Demographics
NPI:1235417221
Name:MILHOAN, ELLEN MARIE (PTA)
Entity Type:Individual
Prefix:MISS
First Name:ELLEN
Middle Name:MARIE
Last Name:MILHOAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-3139
Mailing Address - Country:US
Mailing Address - Phone:330-692-8241
Mailing Address - Fax:
Practice Address - Street 1:250 CONTINENTAL DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-2508
Practice Address - Country:US
Practice Address - Phone:330-332-0317
Practice Address - Fax:330-332-0318
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02842225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant