Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | 1258 | OH |
Y | 111NR0400X | Rehabilitation Chiropractor | 1258 | OH |
NPI | 1063535847 |
---|---|
Provider Name | Dr. Bernard J Miller |
First Address | Columbus, OH 43213 |
Second Address | Columbus, OH 43213 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 26/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0852582 | (05) | OH |
U26415 | (02) | OH |