Provider Demographics
NPI:1912044074
Name:MILLER, STANLEY MORRIS (DC)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:MORRIS
Last Name:MILLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MO
Mailing Address - Zip Code:63379-1306
Mailing Address - Country:US
Mailing Address - Phone:636-528-2100
Mailing Address - Fax:636-528-9166
Practice Address - Street 1:241 FRONT ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MO
Practice Address - Zip Code:63379-1306
Practice Address - Country:US
Practice Address - Phone:636-528-2100
Practice Address - Fax:636-528-9166
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006580111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO116234OtherALLIANCE-BLUECROSSBLUE S
MO343632OtherHEALTHLINK
MO000031553Medicare PIN
MO343632OtherHEALTHLINK