Healthcare Provider Details

I. General information

NPI: 1174096135
Provider Name (Legal Business Name): MILLER PHYSICAL THERAPY AT HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2019
Last Update Date: 01/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 SE 6TH AVE STE 2
DELRAY BEACH FL
33483-5208
US

IV. Provider business mailing address

247 SE 6TH AVE STE 2
DELRAY BEACH FL
33483-5208
US

V. Phone/Fax

Practice location:
  • Phone: 561-278-6055
  • Fax: 561-278-6670
Mailing address:
  • Phone: 561-278-6055
  • Fax: 561-278-6670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. SCOTT EVAN MILLER
Title or Position: OWNER
Credential: MPT
Phone: 561-278-6055