Healthcare Provider Details

I. General information

NPI: 1376916718
Provider Name (Legal Business Name): HILARY MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2015
Last Update Date: 12/31/2022
Certification Date: 12/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 E 6TH ST
ALLIANCE NE
69301-3600
US

IV. Provider business mailing address

16154 CEDAR CANYON RD
FAITH SD
57626-8100
US

V. Phone/Fax

Practice location:
  • Phone: 308-762-5675
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number1254
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number0459
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: