Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CHR.0008190 | CO |
N | 111NN1001X | Nutrition | CHR.0008190 | CO |
NPI | 1033791173 |
---|---|
Provider Name | Dr. Bryan Miller |
First Address | Denver, CO 80230-6836 |
Second Address | Denver, CO 80230-7106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2021 |
Last Update Date | 27/04/2021 |