Provider Demographics
NPI:1245508050
Name:MILLER, ALDON
Entity type:Individual
Prefix:MR
First Name:ALDON
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 JUNO BEACH ST
Mailing Address - Street 2:#204
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-1028
Mailing Address - Country:US
Mailing Address - Phone:603-733-8275
Mailing Address - Fax:
Practice Address - Street 1:3850 JUNO BEACH ST
Practice Address - Street 2:#204
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-1028
Practice Address - Country:US
Practice Address - Phone:603-733-8275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner