Provider Demographics
NPI:1386187417
Name:MILLER, CHRISTINE THOMPSON (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:THOMPSON
Last Name:MILLER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8611 FALLS RUN RD
Mailing Address - Street 2:APT C
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-7343
Mailing Address - Country:US
Mailing Address - Phone:412-913-5473
Mailing Address - Fax:
Practice Address - Street 1:10710 CHARTER DR
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3128
Practice Address - Country:US
Practice Address - Phone:410-644-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26184225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist