Provider Demographics
NPI:1336198498
Name:MILLER, DAVID L (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:MILLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 S CANE
Mailing Address - Street 2:
Mailing Address - City:TOQUERVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84774-5067
Mailing Address - Country:US
Mailing Address - Phone:435-817-8405
Mailing Address - Fax:
Practice Address - Street 1:1490 E FOREMASTER DR
Practice Address - Street 2:SUITE 140
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-4488
Practice Address - Country:US
Practice Address - Phone:435-688-2456
Practice Address - Fax:435-986-4096
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8050028-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist