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General NPI Number Information
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NPI Number | 1467562900
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Entity Type | Individual
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Provider Name | STACI L MILLER PT
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 03/18/2011
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Provider Practice Location Address
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Address Line | 5113 PIPER STATION DR SUITE 202
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City | CHARLOTTE
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State | NC
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Zip | 28277-6689
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Country | US
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Telephone | 980-224-8191
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Fax | 980-224-8194
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Provider Business Mailing Address
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Address Line | 5113 PIPER STATION DR SUITE 202
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City | CHARLOTTE
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State | NC
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Zip | 28277-6689
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Country | US
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Telephone | 980-224-8191
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Fax | 980-224-8194
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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 | 033085-1
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License Number State | NY
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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 | 0400003599
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11833
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License Number State | NC
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