Healthcare Provider Details
I. General information
NPI: 1366170581
Provider Name (Legal Business Name): M E MILLER CHIROPRACTIC CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/15/2022
Last Update Date: 09/27/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1440 N HARBOR BLVD STE 125
FULLERTON CA
92835-4167
US
IV. Provider business mailing address
1440 N HARBOR BLVD STE 125
FULLERTON CA
92835-4167
US
V. Phone/Fax
- Phone: 714-589-2619
- Fax: 714-576-2551
- Phone: 714-589-2619
- Fax: 714-576-2551
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NX0100X |
| Taxonomy | Occupational Health Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MEGHAN
ELIZABETH
MILLER
Title or Position: OWNER
Credential: D.C.
Phone: 714-272-3602