Provider Demographics
NPI:1134531775
Name:MILLER, ROBERT CHARLES (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CHARLES
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 1:28N 100 E
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-2302
Mailing Address - Country:US
Mailing Address - Phone:801-796-7075
Mailing Address - Fax:801-796-7085
Practice Address - Street 1:28N 100 E
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-2302
Practice Address - Country:US
Practice Address - Phone:801-796-7075
Practice Address - Fax:801-796-7085
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT353931-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor