Individual
JAELYN ALEXIS MILAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1306 US HIGHWAY 61, PORTAGEVILLE, MO 63873-8345
(573) 379-6209
Mailing address
1306 US HIGHWAY 61, PORTAGEVILLE, MO 63873-8345
(573) 379-6209
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
MO
Other
Enumeration date
10/19/2023
Last updated
10/19/2023
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