MEDICARE: STEPHANIE S MILLER PT, DPT

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	225100000X	Physical Therapist	7333	AZ

General Provider Information

NPI Number	:	1841675741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE S MILLER PT, DPT

Provider Business Mailing Address
First Line	:	6367 E TANQUE VERDE RD
Second Line	:	130
City	:	TUCSON
State	:	AZ
Zip	:	85715-3829
Country	:	US
Telephone Number	:	520-296-2900
Fax Number	:

Provider Business Practice Location Address
First Line	:	6367 E TANQUE VERDE RD
Second Line	:	130
City	:	TUCSON
State	:	AZ
Zip	:	85715-3829
Country	:	US
Telephone Number	:	520-296-2900
Fax Number	:

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

Provider Enumeration Date	:	07/22/2015
Last Update Date	:	07/22/2015

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