Provider Demographics
NPI:1669029526
Name:MILLER, COLIN (DPT, PT)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 27TH ST UNIT 631
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3253
Mailing Address - Country:US
Mailing Address - Phone:319-327-0885
Mailing Address - Fax:
Practice Address - Street 1:1855 GATEWAY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-3286
Practice Address - Country:US
Practice Address - Phone:925-685-7744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-23
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic