Provider Demographics
NPI:1003980954
Name:MILLER, JOHN D (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:MILLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 SW MILITARY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-1619
Mailing Address - Country:US
Mailing Address - Phone:210-923-3341
Mailing Address - Fax:210-924-9115
Practice Address - Street 1:417 SW MILITARY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-1619
Practice Address - Country:US
Practice Address - Phone:210-923-3341
Practice Address - Fax:210-924-9115
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4487111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor