Provider Demographics
NPI:1487865333
Name:MILLER, LAURA ANNE (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ANNE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 TECHNACENTER DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-6028
Mailing Address - Country:US
Mailing Address - Phone:334-625-5795
Mailing Address - Fax:334-396-4905
Practice Address - Street 1:3405 DALLAS HWY SW
Practice Address - Street 2:SUITE 601
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-6425
Practice Address - Country:US
Practice Address - Phone:770-438-5226
Practice Address - Fax:770-794-4766
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010813225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP01495825OtherMEDICARE RR
GAP01495825OtherMEDICARE RR