Provider Demographics
NPI:1871042523
Name:MILLER, CAROLYN ELIZABETH GHEZZI (MS, PT)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:ELIZABETH GHEZZI
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, PT
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Mailing Address - Street 1:12572 VALLEY VIEW ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92845-2006
Mailing Address - Country:US
Mailing Address - Phone:714-823-4400
Mailing Address - Fax:714-823-4404
Practice Address - Street 1:8935 PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229-6323
Practice Address - Country:US
Practice Address - Phone:804-754-0136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01050051552251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics