Provider Demographics
NPI:1750177572
Name:MILLER, LOUDS
Entity type:Individual
Prefix:
First Name:LOUDS
Middle Name:
Last Name:MILLER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 TAFT AVE SW APT 22855
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-2640
Mailing Address - Country:US
Mailing Address - Phone:616-729-9577
Mailing Address - Fax:
Practice Address - Street 1:5180 KALAMAZOO AVE SE STE CD
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-4817
Practice Address - Country:US
Practice Address - Phone:616-729-9577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501016803172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist