Provider Demographics
NPI:1225720204
Name:MILLER, WHITNEY LYNN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:LYNN
Last Name:MILLER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 COUNTY ROAD 4657
Mailing Address - Street 2:
Mailing Address - City:RHOME
Mailing Address - State:TX
Mailing Address - Zip Code:76078-5145
Mailing Address - Country:US
Mailing Address - Phone:817-688-0350
Mailing Address - Fax:
Practice Address - Street 1:15080 FM 156 STE B
Practice Address - Street 2:
Practice Address - City:JUSTIN
Practice Address - State:TX
Practice Address - Zip Code:76247-7924
Practice Address - Country:US
Practice Address - Phone:940-242-6641
Practice Address - Fax:940-242-6642
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1381000225100000X
TX3130762225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist