Provider Demographics
NPI:1700243698
Name:MILLER, CASEY
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 SUGARLOAF HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:DRUMS
Mailing Address - State:PA
Mailing Address - Zip Code:18222-2910
Mailing Address - Country:US
Mailing Address - Phone:570-234-2544
Mailing Address - Fax:570-209-5760
Practice Address - Street 1:455 SUGARLOAF HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:DRUMS
Practice Address - State:PA
Practice Address - Zip Code:18222-2910
Practice Address - Country:US
Practice Address - Phone:570-234-2544
Practice Address - Fax:570-209-5760
Is Sole Proprietor?:No
Enumeration Date:2016-01-22
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25826225100000X
PAPT024219225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist