MEDICARE: DR. HARRY MATTHEW MILLER DC

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	7013	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1598951691	OTHER	AZ	GROUP NPI

General Provider Information

NPI Number	:	1124110697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRY MATTHEW MILLER DC

Provider Business Mailing Address
First Line	:	425 WEST GUADALUPE RD #113
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85233-3202
Country	:	US
Telephone Number	:	480-926-3102
Fax Number	:	480-926-3103

Provider Business Practice Location Address
First Line	:	425 WEST GUADALUPE RD #113
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85233-3202
Country	:	US
Telephone Number	:	480-926-3102
Fax Number	:	480-926-3103

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

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	10/24/2007

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