Provider Demographics
NPI:1740610872
Name:MILLER, RONI RAE (DC)
Entity Type:Individual
Prefix:
First Name:RONI
Middle Name:RAE
Last Name:MILLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4240 HICKORY LANE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-4642
Mailing Address - Country:US
Mailing Address - Phone:712-274-7246
Mailing Address - Fax:712-274-0037
Practice Address - Street 1:4240 HICKORY LANE
Practice Address - Street 2:SUITE 110
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4642
Practice Address - Country:US
Practice Address - Phone:712-274-7246
Practice Address - Fax:712-274-0037
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007706111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor