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General NPI Number Information
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NPI Number | 1720019599
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Entity Type | Individual
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Provider Name | SCOTT T MILLER PT
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Gender | Male
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 6016 LOVERS LN
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City | PORTAGE
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State | MI
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Zip | 49002-3050
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Country | US
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Telephone | 269-329-0934
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Fax | 269-329-0965
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Provider Business Mailing Address
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Address Line | 13331 PARK WEST BLVD
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City | VICKSBURG
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State | MI
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Zip | 49097-8494
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Country | US
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Telephone |
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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 | 5501009456
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License Number State | MI
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