MEDICARE: TODD LEWIS 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	PT24618	CA

General Provider Information

NPI Number	:	1871576660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD LEWIS MILLER PT

Provider Business Mailing Address
First Line	:	611 ABBOTT ST STE 100
Second Line	:
City	:	SALINAS
State	:	CA
Zip	:	93901-4391
Country	:	US
Telephone Number	:	831-649-1000
Fax Number	:	831-649-4962

Provider Business Practice Location Address
First Line	:	611 ABBOTT ST STE 100
Second Line	:
City	:	SALINAS
State	:	CA
Zip	:	93901-4391
Country	:	US
Telephone Number	:	831-755-3578
Fax Number	:	831-757-4612

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

Provider Enumeration Date	:	11/25/2005
Last Update Date	:	05/09/2018

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