Provider Demographics
NPI:1356056592
Name:MILLER, MARIAH (ATC)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3239 S 840 E APT 35
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8745
Mailing Address - Country:US
Mailing Address - Phone:614-935-1633
Mailing Address - Fax:
Practice Address - Street 1:3239 S 840 E APT 35
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-8745
Practice Address - Country:US
Practice Address - Phone:614-935-1633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer