Provider Demographics
NPI:1922281880
Name:MILLER FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:MILLER FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:601-898-0456
Mailing Address - Street 1:119 COLONY CROSSING WAY
Mailing Address - Street 2:SUITE 700
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-6322
Mailing Address - Country:US
Mailing Address - Phone:601-898-0456
Mailing Address - Fax:601-898-0466
Practice Address - Street 1:119 COLONY CROSSING WAY
Practice Address - Street 2:SUITE 700
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-6322
Practice Address - Country:US
Practice Address - Phone:601-898-0456
Practice Address - Fax:601-898-0466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1117111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty