Provider Demographics
NPI:1568472454
Name:MILLER, RONALD P (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:P
Last Name:MILLER
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2600 GLASGOW AVENUE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-4773
Mailing Address - Country:US
Mailing Address - Phone:302-836-8200
Mailing Address - Fax:302-836-9419
Practice Address - Street 1:2600 GLASGOW AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-4773
Practice Address - Country:US
Practice Address - Phone:302-836-8200
Practice Address - Fax:302-836-9419
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEF10000574111N00000X
NYX00004739-1111N00000X
NY000634-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist