Provider Demographics
NPI:1699261792
Name:MILBURN, RICHARD H
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:H
Last Name:MILBURN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 RIDGEWAY AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-5251
Mailing Address - Country:US
Mailing Address - Phone:812-697-2720
Mailing Address - Fax:
Practice Address - Street 1:COMMUNICARE HEALTHCARE CENTER
Practice Address - Street 2:101 POTTERS LN
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129
Practice Address - Country:US
Practice Address - Phone:812-948-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0501688A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist