Provider Demographics
NPI:1659366227
Name:MILONE, JAMES STEPHEN (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STEPHEN
Last Name:MILONE
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 1:69 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06413-2036
Mailing Address - Country:US
Mailing Address - Phone:860-664-3966
Mailing Address - Fax:860-669-1801
Practice Address - Street 1:69 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:CT
Practice Address - Zip Code:06413-2036
Practice Address - Country:US
Practice Address - Phone:860-664-3966
Practice Address - Fax:860-669-1801
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001207111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTU65402Medicare UPIN