Provider Demographics
NPI:1699850487
Name:MILLER, AMBER (PT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8087 WASHINGTON VILLAGE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-1840
Mailing Address - Country:US
Mailing Address - Phone:937-938-8380
Mailing Address - Fax:937-938-8392
Practice Address - Street 1:8087 WASHINGTON VILLAGE DR STE 101
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-1840
Practice Address - Country:US
Practice Address - Phone:937-938-8380
Practice Address - Fax:937-938-8392
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT06475225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0108341Medicaid
OH000000190966OtherBC/BS
OH382617193-30OtherBWC
OH4044872Medicare Oscar/Certification