Provider Demographics
NPI:1821299256
Name:MILLIKEN, TOM T II (PT)
Entity Type:Individual
Prefix:MR
First Name:TOM
Middle Name:T
Last Name:MILLIKEN
Suffix:II
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 ROUX 61 DRIVE. SOUTH, STE D
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120
Mailing Address - Country:US
Mailing Address - Phone:601-442-3240
Mailing Address - Fax:601-445-9032
Practice Address - Street 1:9 ROUX 61 DRIVE SOUTH, STE D.
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120
Practice Address - Country:US
Practice Address - Phone:601-442-3240
Practice Address - Fax:601-445-9032
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2023-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT0386225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist