Provider Demographics
NPI:1740332642
Name:MILLER CHIROPRACTIC & WELLNESS CENTER , P.L.L.C.
Entity type:Organization
Organization Name:MILLER CHIROPRACTIC & WELLNESS CENTER , P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:304-843-1192
Mailing Address - Street 1:144 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNDSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26041-1029
Mailing Address - Country:US
Mailing Address - Phone:304-843-1192
Mailing Address - Fax:304-843-1197
Practice Address - Street 1:1003 4TH ST
Practice Address - Street 2:
Practice Address - City:MOUNDSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26041-1722
Practice Address - Country:US
Practice Address - Phone:304-843-1192
Practice Address - Fax:304-843-1197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV628111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV5472552OtherAETNA
WV350045307OtherRAILROAD MEDICARE
OH628OtherHEALTH PLAN
WV0775005000Medicaid
WV001710780OtherBCBS
OH233042085-00OtherOHIO WORKERS COMPENSATION
WV3797826-001OtherCIGNA
OHMI0859971Medicare ID - Type Unspecified