Provider Demographics
NPI:1770653040
Name:MILLER, THOMAS HENRY JR (DC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:HENRY
Last Name:MILLER
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 CHELSEA RD
Mailing Address - Street 2:
Mailing Address - City:ABSECON
Mailing Address - State:NJ
Mailing Address - Zip Code:08201-1518
Mailing Address - Country:US
Mailing Address - Phone:609-641-1012
Mailing Address - Fax:
Practice Address - Street 1:22 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08232-2728
Practice Address - Country:US
Practice Address - Phone:609-383-9121
Practice Address - Fax:609-383-9107
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00250700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2056101-014Medicare ID - Type Unspecified