Individual
RICKY LEE MILBOURNE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSA, LSA
Contact information
Practice address
844 BATTLEFIELD BLVD N, CHESAPEAKE, VA 23320-4802
(757) 312-6800
Mailing address
5103 TANGLEWOOD CT, SUFFOLK, VA 23435-2637
(703) 965-6239
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
0136000535
VA
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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