Provider Demographics
NPI:1093809550
Name:MILLER, CHRISTOPHER ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ANDREW
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 1:4462 BRETON RD. SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508
Mailing Address - Country:US
Mailing Address - Phone:616-827-2225
Mailing Address - Fax:616-827-2820
Practice Address - Street 1:4462 BRETON RD. SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-5272
Practice Address - Country:US
Practice Address - Phone:616-827-2225
Practice Address - Fax:616-827-2820
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008699111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION81980Medicare ID - Type Unspecified