Provider Demographics
NPI:1043559792
Name:MILLER CHIROPRACTIC HEALTH CLINIC, INC.
Entity Type:Organization
Organization Name:MILLER CHIROPRACTIC HEALTH CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:D,C,
Authorized Official - Phone:503-472-2523
Mailing Address - Street 1:2270 NE MCDANIEL LN STE A
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-3247
Mailing Address - Country:US
Mailing Address - Phone:503-472-2523
Mailing Address - Fax:503-883-0330
Practice Address - Street 1:2270 NE MCDANIEL LN STE A
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-3247
Practice Address - Country:US
Practice Address - Phone:503-472-2523
Practice Address - Fax:503-883-0330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27-2755111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty