Provider Demographics
NPI:1841871944
Name:MILLER, EMILY (DC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 60TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53140-4099
Mailing Address - Country:US
Mailing Address - Phone:262-657-7744
Mailing Address - Fax:262-657-7753
Practice Address - Street 1:1024 60TH ST STE 1
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-4099
Practice Address - Country:US
Practice Address - Phone:262-657-7744
Practice Address - Fax:262-657-7753
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5646-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor