Individual
DR. MARISA LEE MILLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1404 EASTLAND DR STE 101, BLOOMINGTON, IL 61701-7904
(309) 663-4711
(309) 663-1854
Mailing address
1404 EASTLAND DR STE 101, BLOOMINGTON, IL 61701-7904
(309) 663-4711
(309) 663-1854
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030295
IL
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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