Provider Demographics
NPI:1194907030
Name:MILLER, NICOLE M (PT)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:M
Last Name:MILLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:700 GARDEN VIEW CT
Mailing Address - Street 2:STE 103
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2478
Mailing Address - Country:US
Mailing Address - Phone:760-632-6942
Mailing Address - Fax:760-632-6670
Practice Address - Street 1:7760 EL CAMINO REAL
Practice Address - Street 2:SUITE A
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-8553
Practice Address - Country:US
Practice Address - Phone:760-634-9750
Practice Address - Fax:760-634-9752
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2014-02-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPT34268225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist