Provider Demographics
NPI:1508822453
Name:MILANI, MARIO MARTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARIO
Middle Name:MARTIN
Last Name:MILANI
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 1:4910 MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-2732
Mailing Address - Country:US
Mailing Address - Phone:615-302-1333
Mailing Address - Fax:615-302-3030
Practice Address - Street 1:4910 MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-2732
Practice Address - Country:US
Practice Address - Phone:615-302-1333
Practice Address - Fax:615-302-3030
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU65418Medicare UPIN
TN3678750Medicare ID - Type Unspecified