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General NPI Number Information
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NPI Number | 1093011330
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Entity Type | Organization
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Legal Business Name | MILLER CHIROPRACTIC LIFE CENTER, P.L.L.C.
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Dates
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Enumeration Date | 02/03/2011
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Last Update Date | 02/03/2011
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Provider Practice Location Address
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Address Line | 5601 HIGHLAND RD
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City | WATERFORD
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State | MI
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Zip | 48327-1927
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Country | US
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Telephone | 248-674-7300
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Fax | 248-674-8091
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Provider Business Mailing Address
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Address Line | 5601 HIGHLAND RD
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City | WATERFORD
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State | MI
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Zip | 48327-1927
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Country | US
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Telephone | 248-674-7300
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Fax | 248-674-8091
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. BETTE J. MILLER
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Credential |
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Telephone | 248-674-7300
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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 | 2301004107
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License Number State | MI
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