Provider Demographics
NPI:1265674741
Name:MILLER, ANTHONY J (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
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 1:675 N BARKER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-5937
Mailing Address - Country:US
Mailing Address - Phone:414-988-5055
Mailing Address - Fax:414-988-0034
Practice Address - Street 1:675 N BARKER RD STE 100
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-5937
Practice Address - Country:US
Practice Address - Phone:414-988-5055
Practice Address - Fax:262-988-0034
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-31
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4475111N00000X
WI4475-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor