Provider Demographics
NPI:1619074671
Name:MILLER, JAMES T (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:T
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 1:702 MANGROVE AVE
Mailing Address - Street 2:#303
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3948
Mailing Address - Country:US
Mailing Address - Phone:530-343-3722
Mailing Address - Fax:530-566-1124
Practice Address - Street 1:2062 TALBERT DR
Practice Address - Street 2:SUITE 500
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-7679
Practice Address - Country:US
Practice Address - Phone:530-343-3722
Practice Address - Fax:530-566-1124
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26978111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU73893Medicare UPIN
CADC0269780Medicare ID - Type Unspecified