MEDICARE: DR. MICHAEL A. MILLER, CHIROPRACTIC PHYSICIAN, P.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	111NS0005X	Sports Physician Chiropractor	535	MA

General Provider Information

NPI Number	:	1780088997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. MICHAEL A. MILLER, CHIROPRACTIC PHYSICIAN, P.C.

Provider Business Mailing Address
First Line	:	884 WASHINGTON ST
Second Line	:
City	:	NORWOOD
State	:	MA
Zip	:	02062-3470
Country	:	US
Telephone Number	:	781-762-5600
Fax Number	:	781-769-2100

Provider Business Practice Location Address
First Line	:	884 WASHINGTON ST
Second Line	:
City	:	NORWOOD
State	:	MA
Zip	:	02062-3470
Country	:	US
Telephone Number	:	781-762-5600
Fax Number	:	781-769-2100

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL A. MILLER
Credential	:	D.C.
Telephone Number	:	781-762-5600

Provider Enumeration Date	:	10/17/2014
Last Update Date	:	10/17/2014

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