Provider Demographics
NPI:1750597845
Name:MILLER, CHRISTINE JOYCE (DC)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:JOYCE
Last Name:MILLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W CHURCH ST
Mailing Address - Street 2:STE #3
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-4856
Mailing Address - Country:US
Mailing Address - Phone:707-462-2230
Mailing Address - Fax:253-559-6158
Practice Address - Street 1:101 W CHURCH ST
Practice Address - Street 2:STE #3
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-4856
Practice Address - Country:US
Practice Address - Phone:707-462-2230
Practice Address - Fax:253-559-6158
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17330111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0173300Medicare ID - Type Unspecified
T67059Medicare UPIN