Provider Demographics
NPI:1154908622
Name:MILLER, EMMALINE MICHELLE (DC)
Entity type:Individual
Prefix:
First Name:EMMALINE
Middle Name:MICHELLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4665 WAYNESFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HARROD
Mailing Address - State:OH
Mailing Address - Zip Code:45850-9712
Mailing Address - Country:US
Mailing Address - Phone:567-371-2225
Mailing Address - Fax:
Practice Address - Street 1:7399 SR 366
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43324
Practice Address - Country:US
Practice Address - Phone:937-842-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor