Provider Demographics
NPI:1730139056
Name:MILLER, DAVID M (PT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:M
Last Name:MILLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:39 AMSTERDAM AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-2332
Mailing Address - Country:US
Mailing Address - Phone:215-364-0323
Mailing Address - Fax:215-364-0323
Practice Address - Street 1:412 HUNTINGDON PIKE
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:PA
Practice Address - Zip Code:19046-4448
Practice Address - Country:US
Practice Address - Phone:215-663-8710
Practice Address - Fax:215-663-8717
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT003544L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist