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General NPI Number Information
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NPI Number | 1396218806
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Entity Type | Individual
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Provider Name | MARIA GABRIELA MILLER PT
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Gender | Female
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Dates
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Enumeration Date | 01/07/2019
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Last Update Date | 01/16/2019
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Provider Practice Location Address
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Address Line | 527 N STATE ROUTE 291 STE A
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City | LIBERTY
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State | MO
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Zip | 64068-1045
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Country | US
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Telephone | 816-792-0849
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Fax |
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Provider Business Mailing Address
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Address Line | 5293 FOXRIDGE DR APT 203
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City | MISSION
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State | KS
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Zip | 66202-4525
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Country | US
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Telephone | 913-912-0946
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2018028607
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License Number State | MO
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