Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT871217 | DC |
NPI | 1003115163 |
---|---|
Provider Name | Jeffrey Adam Miller |
First Address | Washington, DC 20001-4545 |
Second Address | Washington, DC 20001-4545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2011 |
Last Update Date | 15/03/2011 |