Provider Demographics
NPI:1326822560
Name:MILLER, ALAN
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
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 1:9600 NUMBER 5 SCHOOL RD NW
Mailing Address - Street 2:
Mailing Address - City:ASH
Mailing Address - State:NC
Mailing Address - Zip Code:28420-2122
Mailing Address - Country:US
Mailing Address - Phone:910-287-6007
Mailing Address - Fax:
Practice Address - Street 1:9600 NUMBER 5 SCHOOL RD NW
Practice Address - Street 2:
Practice Address - City:ASH
Practice Address - State:NC
Practice Address - Zip Code:28420-2122
Practice Address - Country:US
Practice Address - Phone:910-287-6007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15979225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner