Provider Demographics
NPI:1013083989
Name:MILLER, ANTHONY TROY (MSPT)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:TROY
Last Name:MILLER
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 S STONEY POINTE CT
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-3340
Mailing Address - Country:US
Mailing Address - Phone:605-361-7285
Mailing Address - Fax:
Practice Address - Street 1:1232 S STONEY POINTE CT
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-3340
Practice Address - Country:US
Practice Address - Phone:605-361-7285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0603225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0603OtherSTATE LICENSE NUMBER