Provider Demographics
NPI:1336837798
Name:MILOS, RENEE MARIE
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:MARIE
Last Name:MILOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-9564
Mailing Address - Country:US
Mailing Address - Phone:917-754-2640
Mailing Address - Fax:
Practice Address - Street 1:510 W 49TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-3480
Practice Address - Country:US
Practice Address - Phone:917-754-2640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer