Provider Demographics
NPI:1497711501
Name:MILANO, DEBORAH MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:MARIE
Last Name:MILANO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7839 BROAD RIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063
Mailing Address - Country:US
Mailing Address - Phone:803-732-3996
Mailing Address - Fax:803-407-0081
Practice Address - Street 1:7839 BROAD RIVER ROAD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063
Practice Address - Country:US
Practice Address - Phone:803-732-3996
Practice Address - Fax:803-407-0081
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1953111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
350052339OtherRAILROAD MEDICARE
561971088OtherCNC TAX ID
SCCH1953Medicaid
SCCH1953Medicaid