Provider Demographics
NPI:1659401123
Name:MILLER, PAUL R (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:R
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 1:769 W LITTLETON BLVD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-2337
Mailing Address - Country:US
Mailing Address - Phone:303-347-9906
Mailing Address - Fax:303-347-1994
Practice Address - Street 1:769 W LITTLETON BLVD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2337
Practice Address - Country:US
Practice Address - Phone:303-347-9906
Practice Address - Fax:303-347-1994
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3920111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COMIPM0163OtherBLUE CROSS BLUE SHIELD
COMIPM0163OtherBLUE CROSS BLUE SHIELD