Provider Demographics
NPI:1497976146
Name:MILROD, JONATHAN CRAIG (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:CRAIG
Last Name:MILROD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 KATHERINE AVENUE
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901
Mailing Address - Country:US
Mailing Address - Phone:831-422-3558
Mailing Address - Fax:831-422-3020
Practice Address - Street 1:51 KATHERINE AVENUE
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901
Practice Address - Country:US
Practice Address - Phone:831-422-3558
Practice Address - Fax:831-422-3020
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC023062111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0230620Medicare PIN