Provider Demographics
NPI:1063104917
Name:MILEY, DANIEL STEVEN (CMT)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:STEVEN
Last Name:MILEY
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28690 BROADSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-8826
Mailing Address - Country:US
Mailing Address - Phone:562-441-6078
Mailing Address - Fax:
Practice Address - Street 1:28690 BROADSTONE WAY
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-8826
Practice Address - Country:US
Practice Address - Phone:562-441-6078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17700225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist