Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 08001640 | IN |
NPI | 1518987866 |
---|---|
Provider Name | Dr. Trevor Charles Miller |
First Address | North Vernon, IN 47265-1818 |
Second Address | North Vernon, IN 47265-1818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 06/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200087390A | (05) | IN |