Provider Demographics
NPI:1568415933
Name:MILLER, JAMES D (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:MILLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ANDERSON RD E
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:CT
Mailing Address - Zip Code:06784-1023
Mailing Address - Country:US
Mailing Address - Phone:860-210-1345
Mailing Address - Fax:
Practice Address - Street 1:499 FEDERAL RD
Practice Address - Street 2:UNIT #18
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2041
Practice Address - Country:US
Practice Address - Phone:203-775-7102
Practice Address - Fax:203-775-6843
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001282111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT350001060Medicare ID - Type Unspecified
CTU79166Medicare UPIN