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NPI Code Detail

MEDICARE: NATHAN MILLER

MEDICARE: NATHAN 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
1225200000XPhysical Therapy Assistant6072TN

General Provider Information

NPI Number : 1639555147
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN MILLER
Provider Business Mailing Address
First Line : 12 DEER RIDGE LN
Second Line :
City : CARTHAGE
State : TN
Zip : 37030-1567
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3131 TOM AUSTIN HWY
Second Line :
City : SPRINGFIELD
State : TN
Zip : 37172-4801
Country : US
Telephone Number : 615-631-2372
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2015
Last Update Date : 08/06/2015

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