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General NPI Number Information
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NPI Number | 1760930556
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Entity Type | Individual
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Provider Name | GREGORY ALAN MILLER OTR/L
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Gender | Male
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Dates
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Enumeration Date | 09/21/2016
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Last Update Date | 09/17/2018
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Provider Practice Location Address
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Address Line | 104 TYRON CT
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City | GREENWOOD
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State | SC
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Zip | 29649-7200
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Country | US
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Telephone | 864-993-7241
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Fax |
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Provider Business Mailing Address
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Address Line | 104 TRYON CT
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City | GREENWOOD
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State | SC
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Zip | 29649-7200
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Country | US
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Telephone | 864-993-7241
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 3817
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License Number State | SC
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