Provider Demographics
NPI:1689978876
Name:MILNER, KIRA (MPT)
Entity Type:Individual
Prefix:MRS
First Name:KIRA
Middle Name:
Last Name:MILNER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1632 VISTA LUNA
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-3660
Mailing Address - Country:US
Mailing Address - Phone:949-218-8482
Mailing Address - Fax:949-218-8482
Practice Address - Street 1:1632 VISTA LUNA
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-3660
Practice Address - Country:US
Practice Address - Phone:949-218-8482
Practice Address - Fax:949-218-8482
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-02
Last Update Date:2011-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT18615225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist