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General NPI Number Information
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NPI Number | 1578573549
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Entity Type | Individual
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Provider Name | SANDRA MILLER P.T.
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Gender | Female
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 1982 1ST CAPITOL DR
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City | SAINT CHARLES
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State | MO
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Zip | 63301-1609
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Country | US
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Telephone | 636-949-3926
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Fax | 636-949-3928
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Provider Business Mailing Address
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Address Line | 13353 OLIVE BLVD
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3108
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Country | US
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Telephone | 636-358-0437
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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 | 006768
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License Number State | KY
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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 | 103101
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License Number State | MO
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