Healthcare Provider Details

I. General information

NPI: 1255390431
Provider Name (Legal Business Name): DAVID K. MILLER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 01/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116A FOREMAN DR 116-A FOREMAN DR
LAFAYETTE LA
70506-6208
US

IV. Provider business mailing address

2851 JOHNSTON ST STE 514 2851 JOHNSTON ST SUITE 514
LAFAYETTE LA
70503-3243
US

V. Phone/Fax

Practice location:
  • Phone: 337-981-0041
  • Fax: 337-981-0042
Mailing address:
  • Phone: 337-981-0041
  • Fax: 337-981-0211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number522
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: