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General NPI Number Information
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NPI Number | 1154094860
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Entity Type | Individual
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Provider Name | BRADLEY CHRISTOPHER MILLER DPT
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Gender | Male
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Dates
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Enumeration Date | 07/28/2021
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Last Update Date | 07/05/2024
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Provider Practice Location Address
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Address Line | 2501 PARKERS LN
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City | ALEXANDRIA
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State | VA
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Zip | 22306-3209
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Country | US
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Telephone | 702-664-7190
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Fax |
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Provider Business Mailing Address
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Address Line | 9812 WINDING TRAIL DR
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City | OCEAN CITY
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State | MD
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Zip | 21842-9331
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Country | US
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Telephone |
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Fax |
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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 | 2251N0400X
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Taxonomy Name | Neurology Physical Therapist
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License Number | CP032046T
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 10983R
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 2251N0400X
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Taxonomy Name | Neurology Physical Therapist
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License Number | PT210002158
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License Number State | DC
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Taxonomy #4
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Taxonomy Code | 2251N0400X
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Taxonomy Name | Neurology Physical Therapist
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License Number | CP025955T
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License Number State | VA
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