Provider Demographics
NPI:1821697343
Name:MILLER, LUKE CHRISTOPHER (PT)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:CHRISTOPHER
Last Name:MILLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N SENATE AVE UNIT 643
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1259
Mailing Address - Country:US
Mailing Address - Phone:620-257-8289
Mailing Address - Fax:
Practice Address - Street 1:1409 S LAMAR ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75215-1871
Practice Address - Country:US
Practice Address - Phone:620-257-8289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1308337208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN05013593AOtherPT LICENSE
TX1308337OtherPT LICENSE