MEDICARE: MR. WILLIAM NEAL 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
1	208100000X	Physical Medicine & Rehabilitation Physician	PT0002796L	PA
2	225100000X	Physical Therapist	PT0002796L

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001777981	OTHER	PA	HIGHMARK BLUESHIELD
2	0761058000	OTHER	PW	INDEPENDENCE BLUE CROSS
3	0761058000	OTHER		IBC

General Provider Information

NPI Number	:	1427118306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM NEAL MILLER PT

Provider Business Mailing Address
First Line	:	PO BOX 373
Second Line	:
City	:	FOLSOM
State	:	PA
Zip	:	19033-1332
Country	:	US
Telephone Number	:	610-490-3910
Fax Number	:	610-490-3904

Provider Business Practice Location Address
First Line	:	1 EAST BEACON LIGHT LANE
Second Line	:	SUITE B
City	:	CHESTER
State	:	PA
Zip	:	19013-4433
Country	:	US
Telephone Number	:	610-490-3900
Fax Number	:	610-490-3912

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

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	04/06/2012

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