Provider Demographics
NPI:1669624540
Name:MILLER CHIROPRACTIC OF ROCKY MOUNT, PC
Entity type:Organization
Organization Name:MILLER CHIROPRACTIC OF ROCKY MOUNT, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:D
Authorized Official - Last Name:BRABBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-482-4499
Mailing Address - Street 1:PO BOX 7067
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-0067
Mailing Address - Country:US
Mailing Address - Phone:252-446-8800
Mailing Address - Fax:252-446-0080
Practice Address - Street 1:1258 HOME DEPOT PLZ
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-8483
Practice Address - Country:US
Practice Address - Phone:252-446-8800
Practice Address - Fax:252-446-0080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty