Provider Demographics
NPI:1134689409
Name:MILLER, JUSTIN RUDOLPH, JAMES
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:RUDOLPH, JAMES
Last Name:MILLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 LANSING RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-2124
Mailing Address - Country:US
Mailing Address - Phone:330-328-5696
Mailing Address - Fax:
Practice Address - Street 1:376 LANSING RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-2124
Practice Address - Country:US
Practice Address - Phone:330-328-5696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management