Provider Demographics
NPI:1104086446
Name:MILLER-SELLERS, DOLORES K (PT)
Entity type:Individual
Prefix:
First Name:DOLORES
Middle Name:K
Last Name:MILLER-SELLERS
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 1:6303 NW 81ST BLVD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-2976
Mailing Address - Country:US
Mailing Address - Phone:352-381-9445
Mailing Address - Fax:352-378-9523
Practice Address - Street 1:6303 NW 81ST BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653-2976
Practice Address - Country:US
Practice Address - Phone:352-381-9445
Practice Address - Fax:352-378-9523
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19260225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist