Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 10443 | AZ |
Y | 2251X0800X | Physical Therapist - Orthopedic | 10443 | AZ |
NPI | 1053743914 |
---|---|
Provider Name | Erin Marie Miller |
First Address | Phoenix, AZ 85023-1261 |
Second Address | Sun City West, AZ 85375-5855 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2013 |
Last Update Date | 20/01/2014 |