MEDICARE: MRS. JENNIFER P MILLER DPT

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
1	225100000X	Physical Therapist	4980	OR

General Provider Information

NPI Number	:	1235196650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER P MILLER DPT

Provider Business Mailing Address
First Line	:	930 SW ABBEY ST
Second Line	:
City	:	NEWPORT
State	:	OR
Zip	:	97365
Country	:	US
Telephone Number	:	541-265-2244
Fax Number	:	541-768-6774

Provider Business Practice Location Address
First Line	:	930 SW ABBEY ST
Second Line	:
City	:	NEWPORT
State	:	OR
Zip	:	97365-4820
Country	:	US
Telephone Number	:	541-265-2244
Fax Number	:	541-768-6774

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	09/13/2012

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