Provider Demographics
NPI:1124233069
Name:MILLER, STEVEN RAY (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RAY
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 1:5517 ASHLEIGH WALK DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-7684
Mailing Address - Country:US
Mailing Address - Phone:678-482-9691
Mailing Address - Fax:
Practice Address - Street 1:920 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:IL
Practice Address - Zip Code:62837-2365
Practice Address - Country:US
Practice Address - Phone:678-577-9141
Practice Address - Fax:770-232-9403
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008085111N00000X
IL038.006854111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor