Healthcare Provider Details

I. General information

NPI: 1114608957
Provider Name (Legal Business Name): EMILY HARL MILLER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY HARL MILLER

II. Dates (important events)

Enumeration Date: 07/25/2023
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W POPLAR ST
ROGERS AR
72756-4242
US

IV. Provider business mailing address

3407 SW GIBSON AVE
BENTONVILLE AR
72712-4993
US

V. Phone/Fax

Practice location:
  • Phone: 479-631-7678
  • Fax:
Mailing address:
  • Phone: 573-355-0723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number5305
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: