# KEENAN MILONAS M.D. PROFESSIONAL SERVICES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KEENAN MILONAS M.D. PROFESSIONAL SERVICES PLLC
- **Other names:** CUSTOM MD, CUSTOM MEDICINE MD
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1013665751
- **Legal business name:** KEENAN MILONAS M.D. PROFESSIONAL SERVICES PLLC
- **Authorized official:** CIARA LOPEZ (ASSISTANT MANAGER)
- **Authorized official phone:** (509) 241-3541

## Contact information

- **Practice address:** 2207 N MOLTER RD STE 100, LIBERTY LAKE, WA 99019-7571
- **Practice address phone:** (509) 241-3541
- **Practice address fax:** (509) 254-6117
- **Mailing address:** 2207 N MOLTER RD STE 100, LIBERTY LAKE, WA 99019-7571
- **Mailing address phone:** (509) 241-3541
- **Mailing address fax:** (509) 254-6117

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/11/2022
- **Last updated:** 03/11/2022