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General NPI Number Information
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NPI Number | 1023073202
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Entity Type | Individual
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Provider Name | JUSTIN TODD MILLER D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 107 GRANDVIEW AVE
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City | CHICORA
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State | PA
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Zip | 16025-2136
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Country | US
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Telephone | 724-607-1160
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Fax | 724-607-1161
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Provider Business Mailing Address
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Address Line | 109 GRANDVIEW AVENUE
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City | CHICORA
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State | PA
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Zip | 16025
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Country | US
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Telephone | 724-607-1160
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Fax | 724-607-1161
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC008931
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 3905
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License Number State | IA
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