Provider Demographics
NPI:1124507249
Name:MILLER, ROSS WOODRUFF (DC)
Entity type:Individual
Prefix:
First Name:ROSS
Middle Name:WOODRUFF
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 1:1986 N HILL FIELD RD STE 7A
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-2112
Mailing Address - Country:US
Mailing Address - Phone:801-820-6303
Mailing Address - Fax:
Practice Address - Street 1:1986 N HILL FIELD RD STE 7A
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-2112
Practice Address - Country:US
Practice Address - Phone:801-820-6303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10936809-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor