Provider Demographics
NPI:1841620416
Name:MILLER, JARAD (PT)
Entity type:Individual
Prefix:
First Name:JARAD
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15825 W MAPLE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-8252
Mailing Address - Country:US
Mailing Address - Phone:402-885-8855
Mailing Address - Fax:402-885-8859
Practice Address - Street 1:15825 W MAPLE RD STE 102
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-8252
Practice Address - Country:US
Practice Address - Phone:402-885-8855
Practice Address - Fax:402-885-8859
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2586225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist