Provider Demographics
NPI:1841675741
Name:MILLER, STEPHANIE S (PT, DPT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:S
Last Name:MILLER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6367 E TANQUE VERDE RD
Mailing Address - Street 2:130
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3829
Mailing Address - Country:US
Mailing Address - Phone:520-296-2900
Mailing Address - Fax:
Practice Address - Street 1:6367 E TANQUE VERDE RD
Practice Address - Street 2:130
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3829
Practice Address - Country:US
Practice Address - Phone:520-296-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7333225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist