Provider Demographics
NPI:1669665709
Name:MILASICH CHIROPRACTIC PS INC
Entity Type:Organization
Organization Name:MILASICH CHIROPRACTIC PS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILASICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-565-2225
Mailing Address - Street 1:6615 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-2027
Mailing Address - Country:US
Mailing Address - Phone:253-565-2225
Mailing Address - Fax:
Practice Address - Street 1:6615 6TH AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-2027
Practice Address - Country:US
Practice Address - Phone:253-565-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty