Provider Demographics
NPI:1801068580
Name:MILLER, LANCE ADAM (DC)
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:ADAM
Last Name:MILLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5670 THE ALAMEDA STE A
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2739
Mailing Address - Country:US
Mailing Address - Phone:410-433-5132
Mailing Address - Fax:443-977-6106
Practice Address - Street 1:5670 THE ALAMEDA STE A
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2739
Practice Address - Country:US
Practice Address - Phone:410-433-5132
Practice Address - Fax:443-977-6106
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03546111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor