Healthcare Provider Details

I. General information

NPI: 1871576660
Provider Name (Legal Business Name): TODD LEWIS MILLER PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2005
Last Update Date: 05/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 ABBOTT ST STE 100
SALINAS CA
93901-4391
US

IV. Provider business mailing address

611 ABBOTT ST STE 100
SALINAS CA
93901-4391
US

V. Phone/Fax

Practice location:
  • Phone: 831-755-3578
  • Fax: 831-757-4612
Mailing address:
  • Phone: 831-649-1000
  • Fax: 831-649-4962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT24618
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: