Provider Demographics
NPI:1770665614
Name:MILLER, CHAD J (PT)
Entity type:Individual
Prefix:MR
First Name:CHAD
Middle Name:J
Last Name:MILLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:1166 COUNTY ROAD 1175
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-1389
Mailing Address - Country:US
Mailing Address - Phone:419-447-7203
Mailing Address - Fax:419-447-5577
Practice Address - Street 1:651 W MARION RD
Practice Address - Street 2:
Practice Address - City:MOUNT GILEAD
Practice Address - State:OH
Practice Address - Zip Code:43338-1027
Practice Address - Country:US
Practice Address - Phone:419-946-5015
Practice Address - Fax:419-949-3116
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH008945225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist