Healthcare Provider Details

I. General information

NPI: 1891866075
Provider Name (Legal Business Name): CHRISTOPHER LEN MILLER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 09/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3570 S VAL VISTA DR STE 110
GILBERT AZ
85297-7327
US

IV. Provider business mailing address

4864 E BASELINE RD STE 105
MESA AZ
85206-4629
US

V. Phone/Fax

Practice location:
  • Phone: 480-899-9923
  • Fax: 480-899-0196
Mailing address:
  • Phone: 480-558-1900
  • Fax: 480-633-6086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number19914
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8040
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: