Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 2411 | AL |
NPI | 1417386384 |
---|---|
Provider Name | Dr. Jeffery Kevin Miller |
First Address | Auburn, AL 36879-5430 |
Second Address | Auburn, AL 36832-5813 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2013 |
Last Update Date | 01/11/2013 |