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General NPI Number Information
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NPI Number | 1295391233
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Entity Type | Individual
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Provider Name | NATHAN DAVID MILLER
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Gender | Male
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Dates
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Enumeration Date | 05/15/2019
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Last Update Date | 05/15/2019
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Provider Practice Location Address
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Address Line | 618 COBURN AVE
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City | WORLAND
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State | WY
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Zip | 82401-3314
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Country | US
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Telephone | 307-347-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 618 COBURN AVE
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City | WORLAND
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State | WY
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Zip | 82401-3314
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Country | US
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Telephone | 435-695-8290
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 792
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License Number State | WY
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