Provider Demographics
NPI:1578606372
Name:MILLER, SCOTT H (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:H
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 1:411 COUNTY ROAD UU
Mailing Address - Street 2:PO BOX 466
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-7576
Mailing Address - Country:US
Mailing Address - Phone:715-386-9500
Mailing Address - Fax:715-386-2507
Practice Address - Street 1:411 COUNTY ROAD UU
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-7576
Practice Address - Country:US
Practice Address - Phone:715-386-9500
Practice Address - Fax:715-386-2507
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2459 - 012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39-2000321OtherTAX ID NUMBER
WI35313Medicare ID - Type Unspecified
MN27F60MIMedicare UPIN