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NPI Code Detail

MEDICARE: MRS. KIM MILLER P.T

MEDICARE:  MRS. KIM  MILLER  P.T
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 TherapistR0728MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16400127OTHERMOMEDICARE COMPLETE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
26400127OTHERMOUNITED HEALTH CARE
3320062OTHERMOHEALTH PARTNERS
4127499OTHERMOBLUE CROSS BLUE SHIELD
5124158OTHERMOHEALTHLINK

General Provider Information

NPI Number : 1285640854
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIM MILLER P.T
Provider Business Mailing Address
First Line : 113 HILLTOP VILLAGE CENTER DR
Second Line : SUITE B
City : EUREKA
State : MO
Zip : 63025-1108
Country : US
Telephone Number : 636-938-9373
Fax Number : 636-938-9373
Provider Business Practice Location Address
First Line : 113 HILLTOP VILLAGE CENTER DR
Second Line : SUITE B
City : EUREKA
State : MO
Zip : 63025-1108
Country : US
Telephone Number : 636-938-9373
Fax Number : 636-938-9373
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2006
Last Update Date : 03/14/2008

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Directions to “ MRS. KIM MILLER P.T” Practice Location

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