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General NPI Number Information
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NPI Number | 1407962582
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Entity Type | Individual
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Provider Name | MICHAEL C MINER MPT
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Gender | Male
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 2453 GUM BRANCH ROAD SUITE 600
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City | JACKSONVILLE
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State | NC
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Zip | 28540
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Country | US
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Telephone | 910-353-9800
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Fax | 910-455-2083
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Provider Business Mailing Address
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Address Line | 2453 GUM BRANCH RD STE 600
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City | JACKSONVILLE
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State | NC
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Zip | 28540-4008
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Country | US
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Telephone | 910-353-9800
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Fax | 910-455-2083
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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 | 1182
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License Number State | SD
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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 | P8304
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License Number State | NC
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