Healthcare Provider Details
I. General information
NPI: 1083283782
Provider Name (Legal Business Name): DANIELLA MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/18/2021
Last Update Date: 06/18/2021
Certification Date: 06/18/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6740 GUINNESS CIR
WESTFIELD CENTER OH
44251-9724
US
IV. Provider business mailing address
6740 GUINNESS CIR
WESTFIELD CENTER OH
44251-9724
US
V. Phone/Fax
- Phone: 330-464-9823
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225200000X |
| Taxonomy | Physical Therapy Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: