Provider Demographics
NPI:1245383835
Name:MILHOLIN, LARRY C (CMT)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:C
Last Name:MILHOLIN
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 LUCILE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-4703
Mailing Address - Country:US
Mailing Address - Phone:209-639-7942
Mailing Address - Fax:
Practice Address - Street 1:1955 LUCILE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209-4703
Practice Address - Country:US
Practice Address - Phone:209-639-7942
Practice Address - Fax:209-951-0448
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath