Provider Demographics
NPI:1821537853
Name:MILLER, KAYLA
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3727 PELL RD
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26537-8231
Mailing Address - Country:US
Mailing Address - Phone:304-680-3111
Mailing Address - Fax:
Practice Address - Street 1:5253 NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:MARKLEYSBURG
Practice Address - State:PA
Practice Address - Zip Code:15459-1025
Practice Address - Country:US
Practice Address - Phone:724-329-5545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT291901225100000X
WVPT 003722225100000X
PAPT027564225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist