MEDICARE: MILLER CHIROPRACTIC CLINIC PC

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	111N00000X	Chiropractor	08001640A	IN

General Provider Information

NPI Number	:	1568630929
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLER CHIROPRACTIC CLINIC PC

Provider Business Mailing Address
First Line	:	209 S STATE ST
Second Line	:
City	:	NORTH VERNON
State	:	IN
Zip	:	47265-1818
Country	:	US
Telephone Number	:	812-346-1757
Fax Number	:	812-346-3595

Provider Business Practice Location Address
First Line	:	209 S. STATE STREET
Second Line	:
City	:	NORTH VERNON
State	:	IN
Zip	:	47265-1818
Country	:	US
Telephone Number	:	812-346-1757
Fax Number	:	812-346-3595

Authorized Official
Title or Position	:	CHIROPRACTOR/OWNER
Name	:	DR. TREVOR C MILLER
Credential	:	D.C.
Telephone Number	:	812-346-1757

Provider Enumeration Date	:	02/19/2008
Last Update Date	:	05/05/2008

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