Provider Demographics
NPI:1710289178
Name:SEAN M MILLER DC PLLC
Entity Type:Organization
Organization Name:SEAN M MILLER DC PLLC
Other - Org Name:PALIC MILLER CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-766-7100
Mailing Address - Street 1:56 EDWARDS VILLAGE BLVD
Mailing Address - Street 2:UNIT 114
Mailing Address - City:EDWARDS
Mailing Address - State:CO
Mailing Address - Zip Code:81632-7802
Mailing Address - Country:US
Mailing Address - Phone:970-766-7100
Mailing Address - Fax:
Practice Address - Street 1:56 EDWARDS VILLAGE BLVD
Practice Address - Street 2:UNIT 114
Practice Address - City:EDWARDS
Practice Address - State:CO
Practice Address - Zip Code:81632-7802
Practice Address - Country:US
Practice Address - Phone:970-766-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6578111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty