Provider Demographics
NPI:1558566240
Name:MILLIER, ALLAN ROSS (RPT)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:ROSS
Last Name:MILLIER
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 N 6TH ST
Mailing Address - Street 2:PMB 2220
Mailing Address - City:EMERY
Mailing Address - State:SD
Mailing Address - Zip Code:57332-2124
Mailing Address - Country:US
Mailing Address - Phone:662-415-0316
Mailing Address - Fax:
Practice Address - Street 1:411 N 6TH ST
Practice Address - Street 2:PMB 2220
Practice Address - City:EMERY
Practice Address - State:SD
Practice Address - Zip Code:57332-2124
Practice Address - Country:US
Practice Address - Phone:662-415-0316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT 00570225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist