Provider Demographics
NPI:1598859373
Name:MILANI, BRIDGET T (DPT)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:T
Last Name:MILANI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 GREER ST STE A-B
Mailing Address - Street 2:
Mailing Address - City:CORDELE
Mailing Address - State:GA
Mailing Address - Zip Code:31015-1920
Mailing Address - Country:US
Mailing Address - Phone:229-273-9445
Mailing Address - Fax:229-273-9447
Practice Address - Street 1:1107 GREER ST STE A-B
Practice Address - Street 2:
Practice Address - City:CORDELE
Practice Address - State:GA
Practice Address - Zip Code:31015-1920
Practice Address - Country:US
Practice Address - Phone:229-273-9445
Practice Address - Fax:229-273-9447
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT005830225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP28105Medicare UPIN
GA65BBDMJMedicare ID - Type Unspecified