Provider Demographics
NPI:1013665751
Name:KEENAN MILONAS M.D. PROFESSIONAL SERVICES PLLC
Entity Type:Organization
Organization Name:KEENAN MILONAS M.D. PROFESSIONAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CIARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-241-3541
Mailing Address - Street 1:2207 N MOLTER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-7571
Mailing Address - Country:US
Mailing Address - Phone:509-241-3541
Mailing Address - Fax:509-254-6117
Practice Address - Street 1:2207 N MOLTER RD STE 100
Practice Address - Street 2:
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-7571
Practice Address - Country:US
Practice Address - Phone:509-241-3541
Practice Address - Fax:509-254-6117
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KEENAN MILONAS M.D. PROFESSIONAL SERVICES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty