Provider Demographics
NPI:1801278379
Name:MILLER CHIROPRACTIC PHYSICIAN LLC
Entity type:Organization
Organization Name:MILLER CHIROPRACTIC PHYSICIAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMANDER
Authorized Official - Prefix:DR
Authorized Official - First Name:DYLAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-643-3696
Mailing Address - Street 1:729 SEWARD ST STE 4
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:NE
Mailing Address - Zip Code:68434-2069
Mailing Address - Country:US
Mailing Address - Phone:402-643-3696
Mailing Address - Fax:
Practice Address - Street 1:729 SEWARD ST STE 4
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:NE
Practice Address - Zip Code:68434-2069
Practice Address - Country:US
Practice Address - Phone:402-643-3696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILLER CHIROPRACTIC PHYSICIAN LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1832111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty