Provider Demographics
NPI:1790095552
Name:MILLER, MAGGIE M (DC)
Entity Type:Individual
Prefix:DR
First Name:MAGGIE
Middle Name:M
Last Name:MILLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:102 N ABINGTON RD
Mailing Address - Street 2:SUITE 101D
Mailing Address - City:CLARKS GREEN
Mailing Address - State:PA
Mailing Address - Zip Code:18411-2300
Mailing Address - Country:US
Mailing Address - Phone:570-586-7886
Mailing Address - Fax:570-586-7886
Practice Address - Street 1:102 N ABINGTON RD
Practice Address - Street 2:SUITE 101D
Practice Address - City:CLARKS GREEN
Practice Address - State:PA
Practice Address - Zip Code:18411-2300
Practice Address - Country:US
Practice Address - Phone:570-586-7886
Practice Address - Fax:570-586-7886
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010532111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor