Provider Demographics
NPI:1306212055
Name:MILLER, JEFFREY J (DPT)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:J
Last Name:MILLER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 E EUCLID AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-2330
Mailing Address - Country:US
Mailing Address - Phone:856-427-9311
Mailing Address - Fax:856-427-9310
Practice Address - Street 1:76 E EUCLID AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-2330
Practice Address - Country:US
Practice Address - Phone:856-427-9311
Practice Address - Fax:856-427-9310
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01623700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist