Provider Demographics
NPI:1750322616
Name:MILAZZO, GINA FELICIA (PT)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:FELICIA
Last Name:MILAZZO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 DAVENPORT AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-3308
Mailing Address - Country:US
Mailing Address - Phone:989-497-6040
Mailing Address - Fax:989-497-6054
Practice Address - Street 1:3525 DAVENPORT AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3308
Practice Address - Country:US
Practice Address - Phone:989-497-6040
Practice Address - Fax:989-497-6054
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI236632225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist