Healthcare Provider Details

I. General information

NPI: 1780088997
Provider Name (Legal Business Name): DR. MICHAEL A. MILLER, CHIROPRACTIC PHYSICIAN, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 10/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

884 WASHINGTON ST
NORWOOD MA
02062-3470
US

IV. Provider business mailing address

884 WASHINGTON ST
NORWOOD MA
02062-3470
US

V. Phone/Fax

Practice location:
  • Phone: 781-762-5600
  • Fax: 781-769-2100
Mailing address:
  • Phone: 781-762-5600
  • Fax: 781-769-2100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number535
License Number StateMA

VIII. Authorized Official

Name: DR. MICHAEL A. MILLER
Title or Position: PRESIDENT
Credential: D.C.
Phone: 781-762-5600