Healthcare Provider Details

I. General information

NPI: 1972976009
Provider Name (Legal Business Name): JEFFREY MILLER MOT, OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2015
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 RIVERPOINT DR
WEDOWEE AL
36278-7276
US

IV. Provider business mailing address

301 RIVERPOINT DR
WEDOWEE AL
36278-7276
US

V. Phone/Fax

Practice location:
  • Phone: 256-914-9696
  • Fax:
Mailing address:
  • Phone: 256-914-9696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number5050
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: