Provider Demographics
NPI:1811080955
Name:MILLER-MEIER LIMB AND BRACE INC
Entity type:Organization
Organization Name:MILLER-MEIER LIMB AND BRACE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO,VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:E
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:563-344-4206
Mailing Address - Street 1:4505 UTICA RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-1641
Mailing Address - Country:US
Mailing Address - Phone:563-344-4206
Mailing Address - Fax:
Practice Address - Street 1:4505 UTICA RIDGE RD
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-1641
Practice Address - Country:US
Practice Address - Phone:563-344-4206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0118281Medicaid
IL=========001Medicaid
IA0936870001Medicare ID - Type Unspecified
IA0118281Medicaid