Provider Demographics
NPI:1255339982
Name:MILLER, MICHAEL DION (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DION
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 1:2642 N ELLIS ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-1767
Mailing Address - Country:US
Mailing Address - Phone:480-244-7033
Mailing Address - Fax:480-855-9407
Practice Address - Street 1:2050 N ALMA SCHOOL RD
Practice Address - Street 2:#13
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2887
Practice Address - Country:US
Practice Address - Phone:480-244-7033
Practice Address - Fax:480-855-9407
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ115779Medicare PIN
U61036Medicare UPIN