Healthcare Provider Details

I. General information

NPI: 1578217352
Provider Name (Legal Business Name): JARREN MILLER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 S STATE ST
PRESTON ID
83263-1243
US

IV. Provider business mailing address

8 S STATE ST
PRESTON ID
83263-1243
US

V. Phone/Fax

Practice location:
  • Phone: 208-852-2240
  • Fax:
Mailing address:
  • Phone: 435-265-6940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIA-2292
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: