MEDICARE: ANGELA MILLER OTR/L

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	225X00000X	Occupational Therapist	OC004037L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01363102	OTHER	PA	CAPITAL BLUE CROSS
2	279588	OTHER	PA	MAMSI
3	001797549, 171	OTHER	PA	MEDICAL ASSISTANCE
4	MI2276	OTHER	PA	HIGHMARK BLUE SHIELD

General Provider Information

NPI Number	:	1457351157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA MILLER OTR/L

Provider Business Mailing Address
First Line	:	1655 WALKER RD
Second Line	:
City	:	CHAMBERSBURG
State	:	PA
Zip	:	17201-9704
Country	:	US
Telephone Number	:	717-263-7713
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 FRANKLIN FARM LANE
Second Line	:
City	:	CHAMBERSBURG
State	:	PA
Zip	:	17202
Country	:	US
Telephone Number	:	717-263-5147
Fax Number	:	717-263-3454

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

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	08/19/2013

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