Individual
ERIC SHANE MILLEDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5022 S 114TH ST STE 100, OMAHA, NE 68137-2329
(402) 630-0018
Mailing address
215 E ORCHARD AVE, COUNCIL BLUFFS, IA 51503-0419
(712) 313-8087
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
04/01/2025
Last updated
04/01/2025
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