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NPI Code Detail

MEDICARE: LISA MARIE MILLER PT

MEDICARE: LISA MARIE MILLER PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist9316NC

General Provider Information

NPI Number : 1164549408
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARIE MILLER PT
Provider Business Mailing Address
First Line : 7014 SMITH CORNERS BLVD # 1153
Second Line :
City : CHARLOTTE
State : NC
Zip : 28269-3793
Country : US
Telephone Number : 704-649-4177
Fax Number :
Provider Business Practice Location Address
First Line : 7014 SMITH CORNERS BLVD.
Second Line : #1153
City : CHARLOTTE
State : NC
Zip : 28269-3793
Country : US
Telephone Number : 704-649-4177
Fax Number : 704-649-4177
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2007
Last Update Date : 01/21/2022

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Directions to “ LISA MARIE MILLER PT” Practice Location

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