Provider Demographics
NPI:1679828230
Name:MILANOWSKI, MICHELLE LEE
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEE
Last Name:MILANOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 MICHELLE WITMER MEMORIAL DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-5292
Mailing Address - Country:US
Mailing Address - Phone:262-821-1588
Mailing Address - Fax:262-821-6644
Practice Address - Street 1:3610 MICHELLE WITMER MEMORIAL DR
Practice Address - Street 2:SUITE 110
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-5292
Practice Address - Country:US
Practice Address - Phone:262-821-1588
Practice Address - Fax:262-821-6644
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other