Healthcare Provider Details

I. General information

NPI: 1063535847
Provider Name (Legal Business Name): BERNARD J MILLER D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 09/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 B COUNTRY CLUB RD
COLUMBUS OH
43213
US

IV. Provider business mailing address

1021B COUNTRY CLUB RD
COLUMBUS OH
43213
US

V. Phone/Fax

Practice location:
  • Phone: 614-762-7312
  • Fax: 888-551-2775
Mailing address:
  • Phone: 614-762-7312
  • Fax: 888-551-2775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number1258
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number1258
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: