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NPI Code Detail

MEDICARE: PATRICK MICHAEL MILLER ATC

MEDICARE: PATRICK MICHAEL MILLER ATC
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
12255A2300XAthletic TrainerRT001636APA

General Provider Information

NPI Number : 1710186739
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK MICHAEL MILLER ATC
Provider Business Mailing Address
First Line : 895 N KEEL RIDGE RD
Second Line :
City : HERMITAGE
State : PA
Zip : 16148-3147
Country : US
Telephone Number : 724-347-3952
Fax Number :
Provider Business Practice Location Address
First Line : 3410 WILMINGTON RD
Second Line :
City : NEW CASTLE
State : PA
Zip : 16105-3210
Country : US
Telephone Number : 724-658-2801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2007
Last Update Date : 07/11/2007

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Directions to “ PATRICK MICHAEL MILLER ATC” Practice Location

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