Provider Demographics
NPI:1477906170
Name:MILLER, CHASE (DPT)
Entity Type:Individual
Prefix:DR
First Name:CHASE
Middle Name:
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 1:20101 E JACKSON DR STE C
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-1956
Mailing Address - Country:US
Mailing Address - Phone:816-807-4433
Mailing Address - Fax:
Practice Address - Street 1:20101 E JACKSON DR STE C
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-1956
Practice Address - Country:US
Practice Address - Phone:816-908-9651
Practice Address - Fax:816-207-2333
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1105361225100000X
MO2016019662225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist