MEDICARE: DR. JUSTIN TODD MILLER D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC008931	PA
2	111NS0005X	Sports Physician Chiropractor	3905	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001444553	OTHER	PA	HIGHMARK BLUE SHIELD
2	410093	OTHER	PA	HEALTH AMERICA/HEALTH ASS
3	7645493	OTHER	PA	AETNA
4	5670386	OTHER	PA	CIGNA HEALTHCARE

General Provider Information

NPI Number	:	1023073202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTIN TODD MILLER D.C.

Provider Business Mailing Address
First Line	:	109 GRANDVIEW AVENUE
Second Line	:
City	:	CHICORA
State	:	PA
Zip	:	16025
Country	:	US
Telephone Number	:	724-607-1160
Fax Number	:	724-607-1161

Provider Business Practice Location Address
First Line	:	107 GRANDVIEW AVE
Second Line	:
City	:	CHICORA
State	:	PA
Zip	:	16025-2136
Country	:	US
Telephone Number	:	724-607-1160
Fax Number	:	724-607-1161

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	03/22/2011

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