Provider Demographics
NPI:1194029074
Name:MILLER, HEATHER ASHLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:ASHLEY
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 1:115 CLOVER ST
Mailing Address - Street 2:#100
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-3266
Mailing Address - Country:US
Mailing Address - Phone:616-392-2166
Mailing Address - Fax:616-396-0589
Practice Address - Street 1:115 CLOVER ST
Practice Address - Street 2:#100
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-3266
Practice Address - Country:US
Practice Address - Phone:616-392-2166
Practice Address - Fax:616-396-0589
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011877111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor