Provider Demographics
NPI:1134820418
Name:CROES, MILTON (DC)
Entity type:Individual
Prefix:DR
First Name:MILTON
Middle Name:
Last Name:CROES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 LAKESIDE LN
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-4135
Mailing Address - Country:US
Mailing Address - Phone:404-512-1664
Mailing Address - Fax:
Practice Address - Street 1:4500 WEST VILLAGE PL SE STE 1011
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-9239
Practice Address - Country:US
Practice Address - Phone:770-805-9977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010477111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor