Provider Demographics
NPI:1063603165
Name:MILLER, RACHAEL R (PT)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:R
Last Name:MILLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5649 DEATSVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:DEATSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36022-6006
Mailing Address - Country:US
Mailing Address - Phone:334-239-0517
Mailing Address - Fax:
Practice Address - Street 1:1945 SCOTTSVILLE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-3376
Practice Address - Country:US
Practice Address - Phone:270-842-8824
Practice Address - Fax:866-927-7754
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4312225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510I650024 PTANMedicare PIN