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General NPI Number Information
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NPI Number | 1205055480
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Entity Type | Organization
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Legal Business Name | TARA D MILLER DC
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 03/29/2010
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Provider Practice Location Address
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Address Line | 2750 DANTZLER DR SUITE 101
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-9006
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Country | US
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Telephone | 843-553-9700
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Fax | 843-553-9731
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Provider Business Mailing Address
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Address Line | 2750 DANTZLER DR SUITE 101
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-9006
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Country | US
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Telephone | 843-553-9700
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Fax | 843-553-9731
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | TARA D MILLER
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Credential | DC
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Telephone | 843-553-9700
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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 | 2873
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License Number State | SC
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