Provider Demographics
NPI:1063463461
Name:MILLER, WAYNE KURT (DC)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:KURT
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 1:731 AKERS RIDGE DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3248
Mailing Address - Country:US
Mailing Address - Phone:404-781-2225
Mailing Address - Fax:404-781-2226
Practice Address - Street 1:731 AKERS RIDGE DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3248
Practice Address - Country:US
Practice Address - Phone:404-781-2225
Practice Address - Fax:404-781-2226
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO07305111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor