Healthcare Provider Details

I. General information

NPI: 1811351711
Provider Name (Legal Business Name): MAKISHA MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8154 PRINCETON GLENDALE RD
WEST CHESTER OH
45069-5883
US

IV. Provider business mailing address

8154 PRINCETON GLENDALE RD
WEST CHESTER OH
45069-5883
US

V. Phone/Fax

Practice location:
  • Phone: 513-328-0512
  • Fax:
Mailing address:
  • Phone: 513-328-0512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number128099
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: