Healthcare Provider Details

I. General information

NPI: 1235108648
Provider Name (Legal Business Name): JAY ROY MILLER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6551 RIDGE RD
PORT RICHEY FL
34668-6836
US

IV. Provider business mailing address

8248 OLD POST RD
PORT RICHEY FL
34668-6327
US

V. Phone/Fax

Practice location:
  • Phone: 727-844-0844
  • Fax:
Mailing address:
  • Phone: 727-842-9959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberCH6223
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: