MEDICARE: AMBER 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	225100000X	Physical Therapist	PT06475	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000190966	OTHER	OH	BC/BS
3	382617193-30	OTHER	OH	BWC

General Provider Information

NPI Number	:	1699850487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER MILLER PT

Provider Business Mailing Address
First Line	:	8087 WASHINGTON VILLAGE DR STE 101
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45458-1840
Country	:	US
Telephone Number	:	937-938-8380
Fax Number	:	937-938-8392

Provider Business Practice Location Address
First Line	:	8087 WASHINGTON VILLAGE DR STE 101
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45458-1840
Country	:	US
Telephone Number	:	937-938-8380
Fax Number	:	937-938-8392

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

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	08/26/2010

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Directions to “ AMBER MILLER PT” Practice Location

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