Provider Demographics
NPI:1912179326
Name:PAUL MILLER CHIROPRACTIC P C
Entity Type:Organization
Organization Name:PAUL MILLER CHIROPRACTIC P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-347-9906
Mailing Address - Street 1:769 W LITTLETON BLVD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-2337
Mailing Address - Country:US
Mailing Address - Phone:303-347-9906
Mailing Address - Fax:303-347-1994
Practice Address - Street 1:769 W LITTLETON BLVD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2337
Practice Address - Country:US
Practice Address - Phone:303-347-9906
Practice Address - Fax:303-347-1994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3920111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1659401123OtherINDIVIDUAL NPI
COU19862Medicare UPIN
COC485508Medicare PIN