MEDICARE: TAYLOR MILLER

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	225X00000X	Occupational Therapist	5195	SC

General Provider Information

NPI Number	:	1265030266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR MILLER

Provider Business Mailing Address
First Line	:	823 S CHURCH ST APT 1438
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29601-4749
Country	:	US
Telephone Number	:	803-493-8028
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 S CAMBRIDGE ST
Second Line	:
City	:	NINETY SIX
State	:	SC
Zip	:	29666-1149
Country	:	US
Telephone Number	:	803-493-8028
Fax Number	:

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

Provider Enumeration Date	:	10/12/2020
Last Update Date	:	10/12/2020

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Directions to “ TAYLOR MILLER ” Practice Location

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