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General NPI Number Information
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NPI Number | 1821743154
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Entity Type | Individual
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Provider Name | DANIEL CLARKE MILLER JR. PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 02/16/2022
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Provider Practice Location Address
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Address Line | 4720 CLEVELAND HEIGHTS BLVD STE 101
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City | LAKELAND
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State | FL
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Zip | 33813-2244
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Country | US
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Telephone | 863-644-0007
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Fax |
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Provider Business Mailing Address
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Address Line | 3223 BERWICK LN
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City | LAKELAND
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State | FL
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Zip | 33810-2984
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT38385
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License Number State | FL
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