Provider Demographics
NPI:1457361123
Name:MILLER, WESLEY AARON (PT)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:AARON
Last Name:MILLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 HYANNIS DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-3231
Mailing Address - Country:US
Mailing Address - Phone:828-242-0343
Mailing Address - Fax:828-684-3612
Practice Address - Street 1:959 MERRIMON AVE STE 103
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-2366
Practice Address - Country:US
Practice Address - Phone:828-242-0343
Practice Address - Fax:828-237-4866
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400225100000X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2336574Medicare ID - Type Unspecified