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General NPI Number Information
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NPI Number | 1619373701
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Entity Type | Organization
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Legal Business Name | MILLER CHIROPRACTIC LLC
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Dates
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Enumeration Date | 11/17/2014
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Last Update Date | 11/17/2014
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Provider Practice Location Address
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Address Line | 84 EAST LAKEWOOD BOULEVARD
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City | HOLLAND
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State | MI
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Zip | 49424
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Country | US
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Telephone | 616-392-2166
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Fax | 616-396-0589
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Provider Business Mailing Address
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Address Line | 84 EAST LAKEWOOD BOULEVARD
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City | HOLLAND
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State | MI
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Zip | 49424
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Country | US
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Telephone | 616-392-2166
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Fax | 616-396-0589
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. CURTIS WADE MILLER
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Credential | D.C.
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Telephone | 217-417-2127
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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 | 2301010002
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License Number State | MI
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