Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT3105 | AR |
NPI | 1003067489 |
---|---|
Provider Name | Catherine Denise Miller |
First Address | North Little Rock, AR 72114-1709 |
Second Address | North Little Rock, AR 72114-1709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2008 |
Last Update Date | 03/10/2008 |