Healthcare Provider Details

I. General information

NPI: 1982910477
Provider Name (Legal Business Name): RAINENE L MILLER C.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2010
Last Update Date: 08/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14100 E JEWELL AVE
AURORA CO
80012-6907
US

IV. Provider business mailing address

19070 E CRESTRIDGE CIR
AURORA CO
80015-5154
US

V. Phone/Fax

Practice location:
  • Phone: 303-378-7871
  • Fax:
Mailing address:
  • Phone: 303-378-7871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number817
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: