Provider Demographics
NPI:1043421027
Name:DR. SHERWIN MILLER CHIROPRACTIC & WELLNESS CENTER
Entity Type:Organization
Organization Name:DR. SHERWIN MILLER CHIROPRACTIC & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERWIN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:SR
Authorized Official - Credentials:DC
Authorized Official - Phone:304-872-2736
Mailing Address - Street 1:500B MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26651-1321
Mailing Address - Country:US
Mailing Address - Phone:304-872-2736
Mailing Address - Fax:304-872-2736
Practice Address - Street 1:500B MAIN ST
Practice Address - Street 2:
Practice Address - City:SUMMERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26651-1321
Practice Address - Country:US
Practice Address - Phone:304-872-2736
Practice Address - Fax:304-872-2736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV7600021000Medicaid
WV7600021000Medicaid
WVU76261Medicare UPIN
WVMI10886741Medicare ID - Type Unspecified