Provider Demographics
NPI:1760930556
Name:MILLER, GREGORY ALAN (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:ALAN
Last Name:MILLER
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 TRYON CT
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-7200
Mailing Address - Country:US
Mailing Address - Phone:864-993-7241
Mailing Address - Fax:
Practice Address - Street 1:104 TYRON CT
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-7200
Practice Address - Country:US
Practice Address - Phone:864-993-7241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-21
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3817225X00000X, 282N00000X, 314000000X, 251E00000X
IA1760930556251G00000X, 261QR0400X, 282N00000X, 283X00000X, 310400000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community Based
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No282N00000XHospitalsGeneral Acute Care Hospital
No283X00000XHospitalsRehabilitation Hospital
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility