Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 30948 | CA |
N | 111NR0400X | Rehabilitation Chiropractor | 6126 | CO |
NPI | 1194965079 |
---|---|
Provider Name | Dr. Jason Everett Miller |
First Address | San Francisco, CA 94111-2100 |
Second Address | San Francisco, CA 94111-2100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2009 |
Last Update Date | 04/03/2009 |