Provider Demographics
NPI:1780571356
Name:MILLER, THERIN II
Entity type:Individual
Prefix:MR
First Name:THERIN
Middle Name:
Last Name:MILLER
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3126 S BOULEVARD # 240
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5308
Mailing Address - Country:US
Mailing Address - Phone:405-301-0188
Mailing Address - Fax:
Practice Address - Street 1:3126 S BOULEVARD # 240
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5308
Practice Address - Country:US
Practice Address - Phone:405-301-0188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist