Provider Demographics
NPI:1205806049
Name:MILBRATH, DENNIS L (DC)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:L
Last Name:MILBRATH
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 1:910 VALLEJO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-5115
Mailing Address - Country:US
Mailing Address - Phone:707-578-7442
Mailing Address - Fax:707-526-9374
Practice Address - Street 1:910 VALLEJO ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-5115
Practice Address - Country:US
Practice Address - Phone:707-578-7442
Practice Address - Fax:707-526-9374
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC11224111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0112240Medicare ID - Type Unspecified