Provider Demographics
NPI:1851508345
Name:MILLAR CHIROPRACTIC ATHENS, LLC
Entity Type:Organization
Organization Name:MILLAR CHIROPRACTIC ATHENS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:BRETT
Authorized Official - Last Name:MILLAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:256-233-1113
Mailing Address - Street 1:PO BOX 1707
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35602-1707
Mailing Address - Country:US
Mailing Address - Phone:256-353-4500
Mailing Address - Fax:256-301-8980
Practice Address - Street 1:1117 HWY 72 EAST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611
Practice Address - Country:US
Practice Address - Phone:256-233-1113
Practice Address - Fax:256-233-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALL290Medicare PIN