Provider Demographics
NPI:1073576997
Name:MILLER, JANELLE GARMS (PT)
Entity Type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:GARMS
Last Name:MILLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:JANELLE
Other - Middle Name:GARMS
Other - Last Name:KAMPF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2309 23RD ST.
Mailing Address - Street 2:P. O. BOX 342
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360-0342
Mailing Address - Country:US
Mailing Address - Phone:712-336-5320
Mailing Address - Fax:712-336-0020
Practice Address - Street 1:2309 23RD ST.
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360-0342
Practice Address - Country:US
Practice Address - Phone:712-336-5320
Practice Address - Fax:712-336-0020
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1778225100000X
IA01405225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0496174Medicaid
IA48484Medicare PIN
IA4568080002Medicare NSC
MN4568080001Medicare NSC