Provider Demographics
NPI:1063505931
Name:MILLER, JENNIFER BRIANA (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:BRIANA
Last Name:MILLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5912 HUBBARD DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4823
Mailing Address - Country:US
Mailing Address - Phone:301-770-1818
Mailing Address - Fax:301-576-7736
Practice Address - Street 1:5912 HUBBARD DRIVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4823
Practice Address - Country:US
Practice Address - Phone:301-770-1818
Practice Address - Fax:301-576-7736
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor