Provider Demographics
NPI:1124319728
Name:MILLER, ADAM RYAN (DC)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:RYAN
Last Name:MILLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15700 E 9 MILE RD
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-3905
Mailing Address - Country:US
Mailing Address - Phone:586-772-7770
Mailing Address - Fax:586-776-3250
Practice Address - Street 1:15700 E 9 MILE RD
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-3905
Practice Address - Country:US
Practice Address - Phone:586-772-7770
Practice Address - Fax:586-776-3250
Is Sole Proprietor?:No
Enumeration Date:2011-04-29
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009815111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor