Healthcare Provider Details

I. General information

NPI: 1306933841
Provider Name (Legal Business Name): MONICA MILLER D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 W REDLANDS BLVD STE L
REDLANDS CA
92373-8032
US

IV. Provider business mailing address

1650 LYNDON FARM CT STE 300
LOUISVILLE KY
40223-5005
US

V. Phone/Fax

Practice location:
  • Phone: 909-335-0059
  • Fax: 909-335-2828
Mailing address:
  • Phone: 951-335-9825
  • Fax: 951-666-5096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 32578
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: